Provider Demographics
NPI:1538387634
Name:CARLTON, HALLIE SMITH (MED, CAC, LPC)
Entity type:Individual
Prefix:MS
First Name:HALLIE
Middle Name:SMITH
Last Name:CARLTON
Suffix:
Gender:F
Credentials:MED, CAC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 MABON STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15835
Mailing Address - Country:US
Mailing Address - Phone:814-952-8446
Mailing Address - Fax:814-952-8446
Practice Address - Street 1:115 MABON STREET
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825
Practice Address - Country:US
Practice Address - Phone:814-938-6340
Practice Address - Fax:814-938-6341
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
PAPC004356101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional