Provider Demographics
NPI:1508593674
Name:HALE, MARY (LPC/MHSP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CONTINENTAL PL STE 105
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-1052
Mailing Address - Country:US
Mailing Address - Phone:615-623-4617
Mailing Address - Fax:
Practice Address - Street 1:105 CONTINENTAL PL STE 105
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-1052
Practice Address - Country:US
Practice Address - Phone:615-623-4617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4985101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional