Provider Demographics
NPI:1942645916
Name:HALE, EINSTEIN (LPC, CADC-III)
Entity Type:Individual
Prefix:MR
First Name:EINSTEIN
Middle Name:
Last Name:HALE
Suffix:
Gender:M
Credentials:LPC, CADC-III
Other - Prefix:
Other - First Name:EINSTEIN
Other - Middle Name:
Other - Last Name:HICKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4725 SE DIVISION ST APT 313
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-1570
Mailing Address - Country:US
Mailing Address - Phone:541-993-7882
Mailing Address - Fax:
Practice Address - Street 1:4725 SE DIVISION ST APT 313
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-1570
Practice Address - Country:US
Practice Address - Phone:541-993-7882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2020-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19-R-08101YA0400X
ORC5178101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)