Provider Demographics
NPI:1619288735
Name:HALL, RUTH ANNE (MSW, LCSW, LCAS-A)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ANNE
Last Name:HALL
Suffix:
Gender:F
Credentials:MSW, LCSW, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12521 TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-1743
Mailing Address - Country:US
Mailing Address - Phone:910-975-0649
Mailing Address - Fax:910-975-0649
Practice Address - Street 1:3205 RANDALL PKWY STE 105
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2565
Practice Address - Country:US
Practice Address - Phone:910-742-9243
Practice Address - Fax:888-746-1787
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0058361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ47329D800Medicare PIN