Healthcare Provider Details

I. General information

NPI: 1083769319
Provider Name (Legal Business Name): KATHERINE A HALL BSSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 CLEVELAND RD W STE B
HURON OH
44839-2717
US

IV. Provider business mailing address

619 SCHEID RD
SANDUSKY OH
44870-8353
US

V. Phone/Fax

Practice location:
  • Phone: 614-483-2177
  • Fax: 419-386-0984
Mailing address:
  • Phone: 419-366-6116
  • Fax: 419-386-0984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS-0026106
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: