Provider Demographics
NPI:1184612848
Name:HALL-ALDERSON, SHARON M (LCSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:HALL-ALDERSON
Suffix:
Gender:F
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:PO BOX 810
Mailing Address - Street 2:
Mailing Address - City:CEDAR BLUFF
Mailing Address - State:VA
Mailing Address - Zip Code:24609-0810
Mailing Address - Country:US
Mailing Address - Phone:276-964-6702
Mailing Address - Fax:276-964-0292
Practice Address - Street 1:160 ROGERS ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:VA
Practice Address - Zip Code:24266-4500
Practice Address - Country:US
Practice Address - Phone:276-889-3785
Practice Address - Fax:276-889-2842
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
09040050151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA288376OtherBLUE CROSS BLUE SHIELD
VA004945522Medicaid
VA004945522Medicaid
VA800003027Medicare PIN