Provider Demographics
NPI:1407586324
Name:HALL, COURTNEY SI'ERRA (MSW, LCSWA, CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:SI'ERRA
Last Name:HALL
Suffix:
Gender:F
Credentials:MSW, LCSWA, CD(DONA)
Other - Prefix:MRS
Other - First Name:COURTNEY
Other - Middle Name:SI'ERRA
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSWA
Mailing Address - Street 1:1907 BUCKMINSTER DR
Mailing Address - Street 2:
Mailing Address - City:WHITSETT
Mailing Address - State:NC
Mailing Address - Zip Code:27377-9335
Mailing Address - Country:US
Mailing Address - Phone:336-255-6858
Mailing Address - Fax:
Practice Address - Street 1:1907 BUCKMINSTER DR
Practice Address - Street 2:
Practice Address - City:WHITSETT
Practice Address - State:NC
Practice Address - Zip Code:27377-9335
Practice Address - Country:US
Practice Address - Phone:336-255-6858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0159341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical