Healthcare Provider Details

I. General information

NPI: 1154285856
Provider Name (Legal Business Name): MEGAN HALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 E MAIN ST
SCHUYLKILL HAVEN PA
17972-1603
US

IV. Provider business mailing address

110 N RIDGE RD
REINHOLDS PA
17569-9501
US

V. Phone/Fax

Practice location:
  • Phone: 570-516-8553
  • Fax:
Mailing address:
  • Phone: 610-500-3540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberAPC001984
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: