Provider Demographics
NPI:1982827077
Name:HALBERG, JAMESON MICHELE (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMESON
Middle Name:MICHELE
Last Name:HALBERG
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 1:78 1/2 PATTON AVENUE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-3315
Mailing Address - Country:US
Mailing Address - Phone:828-707-0723
Mailing Address - Fax:
Practice Address - Street 1:78 1/2 PATTON AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3315
Practice Address - Country:US
Practice Address - Phone:828-707-0723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801085776101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007905Medicaid