Provider Demographics
NPI:1841626918
Name:HALLOCK, STEPHEN JOHN (MS, CAS, LMHC)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:JOHN
Last Name:HALLOCK
Suffix:
Gender:M
Credentials:MS, CAS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1097 FORT HUNTER RD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-4564
Mailing Address - Country:US
Mailing Address - Phone:518-727-2188
Mailing Address - Fax:
Practice Address - Street 1:1097 FORT HUNTER RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-4564
Practice Address - Country:US
Practice Address - Phone:518-727-2188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-22
Last Update Date:2013-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005661-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health