Healthcare Provider Details

I. General information

NPI: 1962330571
Provider Name (Legal Business Name): MRS. MICHELLE LEIGH HALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 HOLMES RUN PKWY STE C4
ALEXANDRIA VA
22304-2860
US

IV. Provider business mailing address

3400 S CLARK ST APT 712
ARLINGTON VA
22202-4058
US

V. Phone/Fax

Practice location:
  • Phone: 703-379-7350
  • Fax:
Mailing address:
  • Phone: 646-902-8637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: