Provider Demographics
NPI:1851532717
Name:HALL, MARILYN PEARLE (LPA; LPC; LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:PEARLE
Last Name:HALL
Suffix:
Gender:F
Credentials:LPA; LPC; LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 BOBCAT CRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4039
Mailing Address - Country:US
Mailing Address - Phone:210-543-2765
Mailing Address - Fax:210-543-2765
Practice Address - Street 1:1222 N MAIN AVE
Practice Address - Street 2:SUITE 740
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5712
Practice Address - Country:US
Practice Address - Phone:210-271-7411
Practice Address - Fax:210-271-9414
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11923101YP2500X
TX10587103T00000X
TX3315106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist