Hall, Lisa D

Hall, Lisa D is an sole proprietor health care provider with primary practice located at 262 3Rd Ave , Avondale Estates GA 30002-1128. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Hall, Lisa D can be contacted via phone (678) 517-9984.

Contact Information

Primary practice address
262 3Rd Ave Avondale Estates GA 30002-1128
Phone: (678) 517-9984
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 1041S0200X 400719 Georgia
Behavioral Health & Social Service Providers / Clinical 1041C0700X CSW003493 Georgia

Profile Details

NPI number 1396973988
LBN Legal business name Hall, Lisa D
Credentials PHD, LCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 23rd, 2009
Last updated May 6th, 2024 - about last year

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 1396973988 NPPES
Georgia MEDICAID 101YMO800X

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