Provider Demographics
NPI:1831482322
Name:KERRI J. HALL LLC
Entity Type:Organization
Organization Name:KERRI J. HALL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:J
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-558-5648
Mailing Address - Street 1:12351 W 96TH TER
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-4409
Mailing Address - Country:US
Mailing Address - Phone:913-558-5648
Mailing Address - Fax:913-962-4248
Practice Address - Street 1:12351 W 96TH TER
Practice Address - Street 2:SUITE 104
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-4409
Practice Address - Country:US
Practice Address - Phone:913-558-5648
Practice Address - Fax:913-962-4248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS20731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS203365008Medicaid