Provider Demographics
NPI:1770382202
Name:HALL, ELIZABETH RYAN (PHD, LMHC, LPC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:RYAN
Last Name:HALL
Suffix:
Gender:
Credentials:PHD, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21407 MORNING MIST WAY
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34637-7623
Mailing Address - Country:US
Mailing Address - Phone:720-544-1539
Mailing Address - Fax:
Practice Address - Street 1:21407 MORNING MIST WAY
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34637-7623
Practice Address - Country:US
Practice Address - Phone:720-544-1539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC6344101YM0800X
FLMH18622101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health