Provider Demographics
NPI:1811466634
Name:HALE-CASE, ELISE LENORE (LMHC, CDPT)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:LENORE
Last Name:HALE-CASE
Suffix:
Gender:F
Credentials:LMHC, CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 TERRY AVE UNIT 806
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1982
Mailing Address - Country:US
Mailing Address - Phone:206-755-9350
Mailing Address - Fax:
Practice Address - Street 1:1216 PINE ST STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1959
Practice Address - Country:US
Practice Address - Phone:206-323-1768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60827813101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACO60797796OtherCDPT
WALH60827813OtherLMHC