Provider Demographics
NPI:1467942904
Name:LEE, HALLE CLARK
Entity type:Individual
Prefix:
First Name:HALLE
Middle Name:CLARK
Last Name:LEE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:HALLE
Other - Middle Name:
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1706 WAYNE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-2240
Mailing Address - Country:US
Mailing Address - Phone:919-734-6676
Mailing Address - Fax:919-734-9050
Practice Address - Street 1:1706 WAYNE MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2240
Practice Address - Country:US
Practice Address - Phone:919-734-6676
Practice Address - Fax:919-734-9050
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-10
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty