Penelope Hale PHD PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301002422 Issued in MI

Legal business name

PENELOPE HALE PHD PC

Practice address

19855 Outer Dr
Suite 103W
Dearborn, MI 48124-2022

Phone

(313) 278-7777

Fax

(313) 359-9778

NPI assigned

Mar 18, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Penelope A Hale, PHDNPI 1700961158

Title

Owner

Phone

(313) 278-7777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Penelope Hale, PH.D

  • Clinical Psychologist
  • Dearborn, MI
  • NPI 1700961158
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1346411220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 BARRINGTON RD",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301721",
            "telephone_number": "313-278-7777",
            "fax_number": "313-359-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19855 OUTER DR",
            "address_2": "SUITE 103W",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242022",
            "telephone_number": "313-278-7777",
            "fax_number": "313-359-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENELOPE HALE PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "PENELOPE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-278-7777",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301002422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pelham Primary Care PC
• Brian John Peltz, RPH
• India Pemberton
• Candace Pendergraft, LLBSW
• Abagayle Pendleton
• Emily Elizabeth Penn-Bialaski, D.O.
• Raina Penn, TLLP
• Treyvon Lamar Pennington
• Leonard R Pennisi, LMSW
• Claire Marie Pennycook, MA, CCC-SLP

• Clinical Psychologist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.