Provider Demographics
NPI:1871965616
Name:HALL, CASIE (MS, CRC, LPCA)
Entity type:Individual
Prefix:
First Name:CASIE
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:MS, CRC, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 WESTGATE DR STE 101
Mailing Address - Street 2:101
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2568
Mailing Address - Country:US
Mailing Address - Phone:252-430-4466
Mailing Address - Fax:
Practice Address - Street 1:3500 WESTGATE DR STE 101
Practice Address - Street 2:101
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2568
Practice Address - Country:US
Practice Address - Phone:252-430-4466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11825101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health