Provider Demographics
NPI:1396199576
Name:HALL, CHRISTINE (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 W WALL ST STE 803
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5124
Mailing Address - Country:US
Mailing Address - Phone:432-254-8646
Mailing Address - Fax:
Practice Address - Street 1:310 W WALL ST STE 803
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5124
Practice Address - Country:US
Practice Address - Phone:432-254-8646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13118101YA0400X
TX72247101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)