Healthcare Provider Details

I. General information

NPI: 1225102023
Provider Name (Legal Business Name): WILLIAM R HALL MA LICENSED PSYCHOLO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 MORRIS STREET
CHARLESTON WV
25301
US

IV. Provider business mailing address

PO BOX 4009
CHARLESTON WV
25364-4009
US

V. Phone/Fax

Practice location:
  • Phone: 304-341-0511
  • Fax: 304-341-0197
Mailing address:
  • Phone: 304-348-1288
  • Fax: 304-348-1262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number271
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number00133
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: