MEDICARE: ASHLEY NICOLE HALL LCSW

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	1041C0700X	Clinical Social Worker	CSW006899	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710512264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY NICOLE HALL LCSW

Provider Business Mailing Address
First Line	:	2402 DAWSON RD STE 6
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31707-2380
Country	:	US
Telephone Number	:	229-999-6804
Fax Number	:	229-466-2661

Provider Business Practice Location Address
First Line	:	2402 DAWSON RD STE 6
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31707-2380
Country	:	US
Telephone Number	:	229-999-6804
Fax Number	:	229-389-2848

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

Provider Enumeration Date	:	03/05/2020
Last Update Date	:	11/15/2022

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