Individual
ERIC JEFFREY HALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
141 E 5600 S STE 105, MURRAY, UT 84107-6180
(801) 995-9534
Mailing address
881 W BAXTER DR STE 100, SOUTH JORDAN, UT 84095-8506
(801) 995-9534
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11743559-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11743559-3501
DEPARTMENT OF OCCUPATIONAL AND PROFESSIONAL LICENSING
UT
01
—
15071335
CAQH PROVIDER ID
UT
Enumeration date
10/14/2020
Last updated
06/21/2022
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