Provider Demographics
NPI:1811084890
Name:HALL, RICK (LICSW, LADC I)
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:HALL
Suffix:
Gender:M
Credentials:LICSW, LADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3670
Mailing Address - Country:US
Mailing Address - Phone:781-241-9240
Mailing Address - Fax:781-836-0830
Practice Address - Street 1:274 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3670
Practice Address - Country:US
Practice Address - Phone:781-241-9240
Practice Address - Fax:781-836-0830
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-09
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1141061041C0700X
MA2278101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0004883Medicare UPIN