Provider Demographics
NPI:1528871597
Name:HALE, BRENDA KAY (LPC)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:KAY
Last Name:HALE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:KAY
Other - Last Name:DALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1307 MITCHELL AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64503-2539
Mailing Address - Country:US
Mailing Address - Phone:816-937-4604
Mailing Address - Fax:
Practice Address - Street 1:1307 MITCHELL AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64503-2539
Practice Address - Country:US
Practice Address - Phone:816-937-4604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025002189101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional