Provider Demographics
NPI:1801409685
Name:HALL, MARI CALDWELLROBINSON (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:MARI
Middle Name:CALDWELLROBINSON
Last Name:HALL
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:MARI
Other - Middle Name:MCKENZIE
Other - Last Name:CALDWELL-ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1108 MERRION AVE APT 401
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-0539
Mailing Address - Country:US
Mailing Address - Phone:919-213-8821
Mailing Address - Fax:
Practice Address - Street 1:900 MLK BLVD STE B
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2601
Practice Address - Country:US
Practice Address - Phone:704-237-4240
Practice Address - Fax:704-246-7190
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0147561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty