MEDICARE: WILLIAM HALMON LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	CC01452	MN

General Provider Information

NPI Number	:	1598291890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM HALMON LPCC

Provider Business Mailing Address
First Line	:	5740 E RIVER RD
Second Line	:	APT. 211
City	:	FRIDLEY
State	:	MN
Zip	:	55432-6155
Country	:	US
Telephone Number	:	612-719-3008
Fax Number	:

Provider Business Practice Location Address
First Line	:	5740 E RIVER RD
Second Line	:	APT. 211
City	:	FRIDLEY
State	:	MN
Zip	:	55432-6155
Country	:	US
Telephone Number	:	612-719-3008
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2017
Last Update Date	:	05/05/2017

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Directions to “ WILLIAM HALMON LPCC” Practice Location

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