Provider Demographics
NPI:1093331266
Name:HALL, BRETT A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BRETT
Middle Name:A
Last Name:HALL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7445 16TH MNR
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-1238
Mailing Address - Country:US
Mailing Address - Phone:630-901-5740
Mailing Address - Fax:
Practice Address - Street 1:7445 16TH MNR
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-1238
Practice Address - Country:US
Practice Address - Phone:630-901-5740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW146561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical