Provider Demographics
NPI:1013408368
Name:HALL, ANTHONY SCOTT (PLADC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:SCOTT
Last Name:HALL
Suffix:
Gender:M
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 21ST ST
Mailing Address - Street 2:
Mailing Address - City:GERING
Mailing Address - State:NE
Mailing Address - Zip Code:69341-2306
Mailing Address - Country:US
Mailing Address - Phone:308-672-9374
Mailing Address - Fax:
Practice Address - Street 1:1509 1ST AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-3106
Practice Address - Country:US
Practice Address - Phone:308-635-1488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1404101YA0400X
NE13347101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)