Clive Russell Hallam, LMFT is a
Marriage & Family Therapist based in Pueblo West, Colorado. Clive Russell Hallam is licensed to practice in Colorado (license number 0001268) and his current practice location is
19 E Abarr Dr, Pueblo West, Colorado. He can be reached at his office (for appointments etc.) via phone at
(435) 817-0155.
NPI number for Clive Russell Hallam is 1811154321 and his current mailing address is Po Box 7425, Pueblo West, Colorado. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1811154321.
Healthcare Provider's Profile
Full Name | Clive Russell Hallam |
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Gender | Male |
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Speciality | Marriage & Family Therapist |
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Location | 19 E Abarr Dr, Pueblo West, Colorado |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1811154321
- Provider Enumeration Date: 05/21/2008
- Last Update Date: 01/18/2021
Medical Identifiers
Medical identifiers for Clive Russell Hallam such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1811154321 | NPI | - | NPPES |
48800074 | Medicaid | CO | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | LMFT 134 (Wyoming) | Secondary |
106H00000X | Marriage & Family Therapist | 8971102-3902 (Utah) | Secondary |
106H00000X | Marriage & Family Therapist | 0001268 (Colorado) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Clive Russell Hallam is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Clive Russell Hallam, LMFT Po Box 7425, Pueblo West, CO 81007-0425 Ph: (435) 817-0155 | Clive Russell Hallam, LMFT 19 E Abarr Dr, Pueblo West, CO 81007-5436 Ph: (435) 817-0155 |
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