Provider Demographics
NPI:1023385614
Name:HALL, TERESE CATHERINE (MA, BC-DMT, LPC)
Entity Type:Individual
Prefix:MS
First Name:TERESE
Middle Name:CATHERINE
Last Name:HALL
Suffix:
Gender:F
Credentials:MA, BC-DMT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 E MAIN ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3058
Mailing Address - Country:US
Mailing Address - Phone:856-722-9043
Mailing Address - Fax:856-727-1715
Practice Address - Street 1:720 E MAIN ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3058
Practice Address - Country:US
Practice Address - Phone:856-722-9043
Practice Address - Fax:856-727-1715
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-26
Last Update Date:2022-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000496101YP2500X
NJ37PC00197200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional