Hackworth, Gale Sandra

Hackworth, Gale Sandra is an individual health care provider with primary practice located at 811 Ship St Ste 4B , Saint Joseph MI 49085-1171. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Hackworth, Gale Sandra can be contacted via phone (269) 985-3618.

Contact Information

Primary practice address
811 Ship St Ste 4B Saint Joseph MI 49085-1171
Phone: (269) 985-3618
Fax: (269) 609-6009
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 6301018315 Michigan
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6301018315 Michigan

Profile Details

NPI number 1710519376
LBN Legal business name Hackworth, Gale Sandra
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 11th, 2020
Last updated Jan 19th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710519376 NPPES
Michigan Other 1699155226 GROUP NPI FOR LIGHTHOUSE BEHAVIORAL HEALTH

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