1407586324 NPI number — COURTNEY SI'ERRA HALL MSW, LCSWA, CD(DONA)

NPI Number: 1407586324
Health Care Provider/Practitioner: COURTNEY SI'ERRA HALL MSW, LCSWA, CD(DONA)

NPI Number : 1407586324 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407586324",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HALL",
    "FirstName": "COURTNEY",
    "MiddleName": "SI'ERRA",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MSW, LCSWA, CD(DONA)",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HALL",
    "OtherFirstName": "COURTNEY",
    "OtherMiddleName": "SI'ERRA",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "MSW, LCSWA",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "1907 BUCKMINSTER DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WHITSETT",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27377-9335",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "336-255-6858",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "331 MARTIN LUTHER KING JR DR UNIT B",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GREENSBORO",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "27406-1620",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "336-638-1907",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/14/2022",
    "LastUpdateDate": "12/02/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1041S0200X",
          "TaxonomyName": "School Social Worker",
          "LicenseNumber": "1115425",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "374J00000X",
          "TaxonomyName": "Doula",
          "LicenseNumber": "12859",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "P015934",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}