Provider Demographics
NPI:1013955970
Name:HALL, JOSEPH EUGENE (LMFT, LPCC, CADC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:EUGENE
Last Name:HALL
Suffix:
Gender:M
Credentials:LMFT, LPCC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 WESTPORT RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-3819
Mailing Address - Country:US
Mailing Address - Phone:502-457-8120
Mailing Address - Fax:270-351-1430
Practice Address - Street 1:708 WESTPORT RD
Practice Address - Street 2:SUITE 103
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-3819
Practice Address - Country:US
Practice Address - Phone:502-457-8120
Practice Address - Fax:270-351-1430
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0726106H00000X
KY1037101YA0400X
KY1024101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100265900Medicaid
11574918OtherCAQH
KY7100265890Medicaid