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NPI 1558154518

NPI 1558154518 : CHANTHA HALL, PLLC : RALEIGH, NC

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General NPI Number Information
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    NPI Number           |    1558154518
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    Entity Type          |    Organization 
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    Legal Business Name  |    CHANTHA HALL, PLLC 
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Dates
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    Enumeration Date     |    05/23/2025
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    Last Update Date     |    05/23/2025
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Provider Practice Location Address
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    Address Line         |    4030 WAKE FOREST RD STE 349 
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    City                 |    RALEIGH
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    State                |    NC
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    Zip                  |    27609-0010
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    Country              |    US
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    Telephone            |    910-556-3171
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 567 
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    City                 |    CARTHAGE
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    State                |    NC
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    Zip                  |    28327-0567
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    Country              |    US
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    Telephone            |    910-556-3171
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     CHANTHA  LANG 
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    Credential           |    LMFT
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    Telephone            |    910-556-3171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    
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    License Number State |    
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