Hall, Fred

Hall, Fred is an individual health care provider with primary practice located at 1225 N State St Maw Suite 210, Jackson MS 39202-2064. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Hall, Fred can be contacted via phone (601) 973-1697.

Contact Information

Primary practice address
1225 N State St Maw Suite 210 Jackson MS 39202-2064
Phone: (601) 973-1697
Fax: (601) 974-6260
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X

Profile Details

NPI number 1518182435
LBN Legal business name Hall, Fred
Credentials LPC, LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2007
Last updated Dec 26th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518182435 NPPES
Mississippi Other 2058298 AETNA PROVIDER NUMBER

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