Provider Demographics
NPI:1124633631
Name:CARBREY, HALLI F (MA, LLPC)
Entity type:Individual
Prefix:
First Name:HALLI
Middle Name:F
Last Name:CARBREY
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 PLYMOUTH RD STE 125
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4080
Mailing Address - Country:US
Mailing Address - Phone:716-604-7815
Mailing Address - Fax:
Practice Address - Street 1:409 PLYMOUTH RD STE 125
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4080
Practice Address - Country:US
Practice Address - Phone:716-604-7815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016338101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional