Provider Demographics
NPI:1366671828
Name:STACEY HALL
Entity Type:Organization
Organization Name:STACEY HALL
Other - Org Name:HALL & ASSOCIATIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:816-977-3178
Mailing Address - Street 1:1715 E CEDAR ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1891
Mailing Address - Country:US
Mailing Address - Phone:816-977-3178
Mailing Address - Fax:816-572-6838
Practice Address - Street 1:1715 E CEDAR ST
Practice Address - Street 2:SUITE 115
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1891
Practice Address - Country:US
Practice Address - Phone:816-977-3178
Practice Address - Fax:816-572-6838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4008174400000X
KS3935251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty