Provider Demographics
NPI:1265589204
Name:HALL, MARO R (LMHC)
Entity type:Individual
Prefix:
First Name:MARO
Middle Name:R
Last Name:HALL
Suffix:
Gender:F
Credentials:LMHC
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 402
Mailing Address - Street 2:
Mailing Address - City:OTIS
Mailing Address - State:MA
Mailing Address - Zip Code:01253-0402
Mailing Address - Country:US
Mailing Address - Phone:413-269-7730
Mailing Address - Fax:
Practice Address - Street 1:60 COTTAGE ST
Practice Address - Street 2:MAIN ST HUMAN RESOURCES BRIEN CENTER
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1302
Practice Address - Country:US
Practice Address - Phone:413-528-9156
Practice Address - Fax:413-528-8187
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5268101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA31730OtherHEALTH NEW ENGLAND