Healthcare Provider Details

I. General information

NPI: 1053407825
Provider Name (Legal Business Name): MICHAEL J HALL PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

543 TAYLOR AVENUE DEPARTMENT OF MENTAL HEALTH AND BEHAVIORAL SCIENCES
COLUMBUS OH
43203
US

IV. Provider business mailing address

543 TAYLOR AVENUE DEPARTMENT OF MENTAL HEALTH AND BEHAVIORAL SCIENCES
COLUMBUS OH
43203
US

V. Phone/Fax

Practice location:
  • Phone: 614-247-5420
  • Fax: 614-257-5418
Mailing address:
  • Phone: 614-247-5420
  • Fax: 614-257-5418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number19556
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number19556
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: