Provider Demographics
NPI:1861605776
Name:HALE, HILARY TARA (LPCC)
Entity type:Individual
Prefix:MS
First Name:HILARY
Middle Name:TARA
Last Name:HALE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 93355
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87199-3355
Mailing Address - Country:US
Mailing Address - Phone:505-238-5524
Mailing Address - Fax:505-856-7339
Practice Address - Street 1:5712 OSUNA RD NE
Practice Address - Street 2:SUITE 4
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-2566
Practice Address - Country:US
Practice Address - Phone:505-238-5524
Practice Address - Fax:505-856-7339
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4481101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor