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General NPI Number Information
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NPI Number | 1750859609
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Entity Type | Individual
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Provider Name | NICOLA J HALL LPC, CSAC, LMT
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Gender | Female
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Dates
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Enumeration Date | 11/08/2018
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 204 KANAWAH RUN
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City | YORKTOWN
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State | VA
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Zip | 23693-2760
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Country | US
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Telephone | 757-876-4946
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Fax |
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Provider Business Mailing Address
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Address Line | 204 KANAWAH RUN
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City | YORKTOWN
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State | VA
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Zip | 23693-2760
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Country | US
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Telephone | 757-876-4946
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0710102956
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701006939
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 0019012154
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701006939
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License Number State | VA
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