Healthcare Provider Details

I. General information

NPI: 1902682800
Provider Name (Legal Business Name): GEORGIA A. HALL BEHAVIOR CONSULTING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 N MAIN ST
KILMARNOCK VA
22482-3822
US

IV. Provider business mailing address

606 CHESAPEAKE DR
WHITE STONE VA
22578-2654
US

V. Phone/Fax

Practice location:
  • Phone: 804-581-0008
  • Fax: 804-404-9550
Mailing address:
  • Phone: 804-581-0008
  • Fax: 804-404-9550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: GEORGIA ABIGAIL HALL
Title or Position: BEHAVIOR ANALYST
Credential: BCBA, LBA
Phone: 804-581-0008