Healthcare Provider Details

I. General information

NPI: 1245788975
Provider Name (Legal Business Name): ADAM M HALL LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2016
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 MARION AVE
MANSFIELD OH
44903-2223
US

IV. Provider business mailing address

902 MOWERY RD
PERRYSVILLE OH
44864-9696
US

V. Phone/Fax

Practice location:
  • Phone: 419-774-9969
  • Fax:
Mailing address:
  • Phone: 419-564-1786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1500495-TRNE
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC.1500495-TRNE
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1700733
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: