Provider Demographics
NPI:1801352547
Name:MCHALE, DAVID BRIAN
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BRIAN
Last Name:MCHALE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 CEDAR CHIP CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-8035
Mailing Address - Country:US
Mailing Address - Phone:443-591-7113
Mailing Address - Fax:
Practice Address - Street 1:6101 OLD HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-1715
Practice Address - Country:US
Practice Address - Phone:410-545-3086
Practice Address - Fax:410-545-7870
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD071631041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool