Provider Demographics
NPI:1710316922
Name:HALE, TOMEKA S (LICSW-PIP, MSW)
Entity Type:Individual
Prefix:MS
First Name:TOMEKA
Middle Name:S
Last Name:HALE
Suffix:
Gender:F
Credentials:LICSW-PIP, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 GOVERNORS DR SW UNIT 7312
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35807-5062
Mailing Address - Country:US
Mailing Address - Phone:205-933-8101
Mailing Address - Fax:256-551-0687
Practice Address - Street 1:500 MARKAVIEW RD NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-3652
Practice Address - Country:US
Practice Address - Phone:205-933-8101
Practice Address - Fax:256-551-0687
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW005988104100000X
AL2679G104100000X
AL4002C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker