Healthcare Provider Details

I. General information

NPI: 1922928944
Provider Name (Legal Business Name): HEATHER HALL MSW, LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 KENNARD ST STE 250
MAPLEWOOD MN
55109-5466
US

IV. Provider business mailing address

3100 KENNARD ST STE 250
MAPLEWOOD MN
55109-5466
US

V. Phone/Fax

Practice location:
  • Phone: 612-801-7119
  • Fax: 651-925-0610
Mailing address:
  • Phone: 612-801-7119
  • Fax: 651-925-0610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: