Provider Demographics
NPI:1083769319
Name:HALL, KATHERINE A (BSSW, LSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:HALL
Suffix:
Gender:F
Credentials:BSSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 SCHEID RD
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-8353
Mailing Address - Country:US
Mailing Address - Phone:419-366-6116
Mailing Address - Fax:419-386-0984
Practice Address - Street 1:509 CLEVELAND RD W STE B
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:OH
Practice Address - Zip Code:44839-2717
Practice Address - Country:US
Practice Address - Phone:614-483-2177
Practice Address - Fax:419-386-0984
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS-0026106104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker