Provider Demographics
NPI:1568674695
Name:HALL, KATHERINE S (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:S
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:P.O.BOX 681
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10506
Mailing Address - Country:US
Mailing Address - Phone:914-749-9083
Mailing Address - Fax:
Practice Address - Street 1:460 OLD POST RD.
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NY
Practice Address - Zip Code:10506
Practice Address - Country:US
Practice Address - Phone:914-749-9083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR031059-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical