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Individual

MARK THOMAS HALE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
255 SPENCER RD STE 101, SAINT PETERS, MO 63376-2574
(636) 939-2550
(636) 939-2551
Mailing address
255 SPENCER RD STE 201, SAINT PETERS, MO 63376-2576
(636) 939-2550
(636) 939-2551

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2024017625
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201844613
LICENSE
MO
01
2024017625
LICENSE
MO
Enumeration date
02/01/2019
Last updated
06/18/2024
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  • EDI platform