Healthcare Provider Details

I. General information

NPI: 1346459955
Provider Name (Legal Business Name): MARY ELIZABETH HALL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH HALL MSW

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 7TH ST SE
WASHINGTON DC
20003-2768
US

IV. Provider business mailing address

2500 Q ST NW 324
WASHINGTON DC
20007-4373
US

V. Phone/Fax

Practice location:
  • Phone: 202-543-4645
  • Fax: 202-543-4645
Mailing address:
  • Phone: 202-342-9287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC303010
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10328
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: