Healthcare Provider Details

I. General information

NPI: 1104745470
Provider Name (Legal Business Name): CHLOE ADELINE HALL MSW, LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3731 LATROBE DR
CHARLOTTE NC
28211-1362
US

IV. Provider business mailing address

414 W 9TH ST APT I
CHARLOTTE NC
28202-1792
US

V. Phone/Fax

Practice location:
  • Phone: 980-224-2708
  • Fax:
Mailing address:
  • Phone: 919-928-6827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP024041
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: