Provider Demographics
NPI:1578338596
Name:HALE, ALLISON (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-4607
Mailing Address - Country:US
Mailing Address - Phone:435-752-1976
Mailing Address - Fax:435-755-6707
Practice Address - Street 1:190 E CENTER ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-4607
Practice Address - Country:US
Practice Address - Phone:435-752-1976
Practice Address - Fax:435-755-6707
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7673766-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical