Basic Information
| Provider Information | |||||||||
| NPI: | 1235689522 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HALL | ||||||||
| FirstName: | WHITNEY | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | ACDP, LCDP, BSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 BAKER ST | ||||||||
| Address2: | |||||||||
| City: | WARWICK | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028860709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4012698271 | ||||||||
| FaxNumber: | 4019419797 | ||||||||
| Practice Location | |||||||||
| Address1: | 160 NARRAGANSETT AVE | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029073367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4019414488 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2016 | ||||||||
| LastUpdateDate: | 10/11/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | CDP00635 | RI | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.