Provider Demographics
NPI:1831646355
Name:HALL, ARLICIA
Entity Type:Individual
Prefix:
First Name:ARLICIA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5812 MONDAVI PLACE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314
Mailing Address - Country:US
Mailing Address - Phone:910-644-4668
Mailing Address - Fax:910-245-4799
Practice Address - Street 1:2543 RAVENHILL DR STE B
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5459
Practice Address - Country:US
Practice Address - Phone:910-339-1928
Practice Address - Fax:910-339-4650
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-22180101YA0400X
NCA13784101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)