Healthcare Provider Details

I. General information

NPI: 1932958014
Provider Name (Legal Business Name): ASHLEY HALL LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3551 COMMERCIAL DR SW
ROCHESTER MN
55902-2883
US

IV. Provider business mailing address

787 NORTHERN HILLS CIR
SAINT CHARLES MN
55972-1499
US

V. Phone/Fax

Practice location:
  • Phone: 507-252-0885
  • Fax:
Mailing address:
  • Phone: 507-316-3465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29886
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: