Provider Demographics
NPI:1881186435
Name:HALL, STEPHANIE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1178
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-0859
Mailing Address - Country:US
Mailing Address - Phone:208-254-0682
Mailing Address - Fax:
Practice Address - Street 1:200 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1422
Practice Address - Country:US
Practice Address - Phone:208-254-0682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID8081101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional