MEDICARE: TAMRA KAY HALL PHD, LPC, LMHC, CCS

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	E.1600084	OH
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	C-02619	MI
3	101YM0800X	Mental Health Counselor	216934
4	101YP2500X	Professional Counselor	6401010124	MI
5	101YP2500X	Professional Counselor	E.1600084	OH
6	1041C0700X	Clinical Social Worker	S-20147	MI
7	101YM0800X	Mental Health Counselor	MH12744	FL

General Provider Information

NPI Number	:	1740501287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMRA KAY HALL PHD, LPC, LMHC, CCS

Provider Business Mailing Address
First Line	:	11958 CYPRESS LINKS DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-8402
Country	:	US
Telephone Number	:	269-830-2110
Fax Number	:

Provider Business Practice Location Address
First Line	:	11958 CYPRESS LINKS DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-8402
Country	:	US
Telephone Number	:	269-830-2110
Fax Number	:

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

Provider Enumeration Date	:	06/18/2010
Last Update Date	:	06/27/2025

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