Provider Demographics
NPI:1518172550
Name:HALL, SCOTT EVAN (PHD, LPCC, NCC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:EVAN
Last Name:HALL
Suffix:
Gender:M
Credentials:PHD, LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 E SCHANTZ AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45419-3820
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5450 FAR HILLS AVE
Practice Address - Street 2:SUITE 222
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-2386
Practice Address - Country:US
Practice Address - Phone:937-287-0945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional