=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487428017
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTA HALL
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/14/2023
-----------------------------------------------------
Last Update Date | 05/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 218 DOGWOOD HOLLOW RD
-----------------------------------------------------
City | MOUNTAIN VIEW
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72560-7942
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-315-3344
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 58155 CHINN ST
-----------------------------------------------------
City | PLAQUEMINE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70764-3601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 171M00000X
-----------------------------------------------------
Taxonomy Name | Case Manager/Care Coordinator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------