Provider Demographics
NPI:1780087221
Name:HALL, EUGENE (PHD, LAMFT)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:
Last Name:HALL
Suffix:
Gender:M
Credentials:PHD, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 E 45TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-5026
Mailing Address - Country:US
Mailing Address - Phone:612-888-1513
Mailing Address - Fax:
Practice Address - Street 1:1994 BUFORD AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-6038
Practice Address - Country:US
Practice Address - Phone:612-888-1513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3375390200000X
MN3755106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program