Healthcare Provider Details

I. General information

NPI: 1659957355
Provider Name (Legal Business Name): ANGELA HALL LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4014 NE 83RD WAY
VANCOUVER WA
98665-1097
US

IV. Provider business mailing address

4014 NE 83RD WAY
VANCOUVER WA
98665-1097
US

V. Phone/Fax

Practice location:
  • Phone: 918-671-0177
  • Fax:
Mailing address:
  • Phone: 918-671-0177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61136135
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: