Provider Demographics
NPI:1497364566
Name:HALE, KARA (LGPC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:HALE
Suffix:
Gender:
Credentials:LGPC
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:
Other - Last Name:POULSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5820 YORK RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-3620
Mailing Address - Country:US
Mailing Address - Phone:410-800-2169
Mailing Address - Fax:
Practice Address - Street 1:5820 YORK RD STE 201
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-3620
Practice Address - Country:US
Practice Address - Phone:410-800-2169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2025-04-21
Deactivation Date:2025-03-10
Deactivation Code:
Reactivation Date:2025-03-21
Provider Licenses
StateLicense IDTaxonomies
MDLGP16322101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health