Provider Demographics
NPI:1881241529
Name:HALE-WEST, GRETCHEN RUTH (LPC)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:RUTH
Last Name:HALE-WEST
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 NEW BRITAIN AVE APT P2
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062-2037
Mailing Address - Country:US
Mailing Address - Phone:203-490-8175
Mailing Address - Fax:
Practice Address - Street 1:1224 MILL ST STE 200
Practice Address - Street 2:
Practice Address - City:EAST BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06023-1159
Practice Address - Country:US
Practice Address - Phone:860-258-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5676101YP2500X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional