MEDICARE: DASHANA L 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	53237	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	53238	OTHER	TX	TEXAS BOARD OF SOCIAL WORK EXAMINERS

General Provider Information

NPI Number	:	1720747546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DASHANA L HALL LCSW

Provider Business Mailing Address
First Line	:	5161 SAN FELIPE ST STE 320
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-3640
Country	:	US
Telephone Number	:	979-475-7210
Fax Number	:

Provider Business Practice Location Address
First Line	:	5161 SAN FELIPE ST, SUITE 320
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-3640
Country	:	US
Telephone Number	:	979-475-7210
Fax Number	:

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

Provider Enumeration Date	:	12/08/2021
Last Update Date	:	02/24/2023

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