Healthcare Provider Details

I. General information

NPI: 1710226717
Provider Name (Legal Business Name): SARAH R HALL LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2013
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 COMMERCE DR BLDG 1
PERRYSBURG OH
43551-5236
US

IV. Provider business mailing address

1070 COMMERCE DR BLDG 1
PERRYSBURG OH
43551-5236
US

V. Phone/Fax

Practice location:
  • Phone: 419-482-8382
  • Fax:
Mailing address:
  • Phone: 194-482-8382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0034697
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC0500498
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: