Basic Information
| Provider Information | |||||||||
| NPI: | 1528436912 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANDERSON | ||||||||
| FirstName: | HALI | ||||||||
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| Credential: | LPCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 130 SOUTHERN SCHOOL RD | ||||||||
| Address2: | |||||||||
| City: | SOMERSET | ||||||||
| State: | KY | ||||||||
| PostalCode: | 425013223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6066794782 | ||||||||
| FaxNumber: | 6066785296 | ||||||||
| Practice Location | |||||||||
| Address1: | 218 COLUMBIA AVE | ||||||||
| Address2: | |||||||||
| City: | GLASGOW | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421412932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2706517070 | ||||||||
| FaxNumber: | 2706517071 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2015 | ||||||||
| LastUpdateDate: | 11/18/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 171939 | KY | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | 260908 | KY | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.