Provider Demographics
NPI:1104441971
Name:CRUTCH, HALLE BRIANA (LPC-A)
Entity type:Individual
Prefix:
First Name:HALLE
Middle Name:BRIANA
Last Name:CRUTCH
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 S KIMBALL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-1524
Mailing Address - Country:US
Mailing Address - Phone:817-756-1440
Mailing Address - Fax:817-796-1233
Practice Address - Street 1:185 S KIMBALL AVE STE 100
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-1524
Practice Address - Country:US
Practice Address - Phone:817-756-1440
Practice Address - Fax:817-796-1233
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90322101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health