Basic Information
| Provider Information | |||||||||
| NPI: | 1588282727 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HALL | ||||||||
| FirstName: | CAROLINE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | LGSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1615 26TH ST S APT 5 | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 222062964 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 650 PENNSYLVANIA AVE SE STE 440 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200034424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2025445440 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2020 | ||||||||
| LastUpdateDate: | 07/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LG50083353 | DC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.