Provider Demographics
NPI:1013022730
Name:HALL, SHARON ELLEN (CNS-BC)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:ELLEN
Last Name:HALL
Suffix:
Gender:F
Credentials:CNS-BC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:HALL
Other - Last Name:CHAMBERLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11532 LINKS DRIVE
Mailing Address - Street 2:
Mailing Address - City:RE
Mailing Address - State:VA
Mailing Address - Zip Code:20190
Mailing Address - Country:US
Mailing Address - Phone:703-437-7285
Mailing Address - Fax:703-437-8410
Practice Address - Street 1:7700 LEESBURG PIKE
Practice Address - Street 2:#200
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2615
Practice Address - Country:US
Practice Address - Phone:703-437-7285
Practice Address - Fax:703-437-8410
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA00150000250364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult