Provider Demographics
NPI:1801260161
Name:HALE, ALYSON (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 BOB WHITE DR
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-8018
Mailing Address - Country:US
Mailing Address - Phone:931-200-9168
Mailing Address - Fax:
Practice Address - Street 1:261 YVONNE AVE
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-4735
Practice Address - Country:US
Practice Address - Phone:931-200-9168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3454101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional