Provider Demographics
NPI:1922154244
Name:HALL, BYRON L (LCSW)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:L
Last Name:HALL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 W 110TH ST
Mailing Address - Street 2:APT. 63
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2477
Mailing Address - Country:US
Mailing Address - Phone:212-662-2677
Mailing Address - Fax:212-662-2677
Practice Address - Street 1:412 W 110TH ST
Practice Address - Street 2:APT. 63
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-2477
Practice Address - Country:US
Practice Address - Phone:212-662-2677
Practice Address - Fax:212-662-2677
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR033037-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical