Provider Demographics
NPI:1396378436
Name:HALL, KAMEEL ALICIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KAMEEL
Middle Name:ALICIA
Last Name:HALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1765 E LITTLE CREEK RD APT 101
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-4212
Mailing Address - Country:US
Mailing Address - Phone:646-346-9566
Mailing Address - Fax:
Practice Address - Street 1:1765 E LITTLE CREEK RD APT 101
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-4212
Practice Address - Country:US
Practice Address - Phone:646-346-9566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA090401144441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty