Healthcare Provider Details

I. General information

NPI: 1588595680
Provider Name (Legal Business Name): EMILY HALL BA & BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 W HARRISON ST
SULLIVAN IL
61951-1907
US

IV. Provider business mailing address

12 W HARRISON ST
SULLIVAN IL
61951-1907
US

V. Phone/Fax

Practice location:
  • Phone: 217-728-4358
  • Fax: 217-728-2270
Mailing address:
  • Phone: 217-728-4358
  • Fax: 217-728-2270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: