Provider Demographics
NPI:1023399565
Name:HALL, DONALD L (LCADC)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:L
Last Name:HALL
Suffix:
Gender:M
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MORGNEC RD
Mailing Address - Street 2:APT. I - 104
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1030
Mailing Address - Country:US
Mailing Address - Phone:410-282-0585
Mailing Address - Fax:
Practice Address - Street 1:6190 GEORGETOWN BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6460
Practice Address - Country:US
Practice Address - Phone:410-552-9004
Practice Address - Fax:410-552-9003
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA055101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)