Provider Demographics
NPI:1285982967
Name:HALLY, LI LIN (LCSW)
Entity type:Individual
Prefix:
First Name:LI LIN
Middle Name:
Last Name:HALLY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LI LIN
Other - Middle Name:
Other - Last Name:HILLIARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:520 SW YAMHILL ST
Mailing Address - Street 2:STE 345
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-1335
Mailing Address - Country:US
Mailing Address - Phone:503-267-4786
Mailing Address - Fax:
Practice Address - Street 1:520 SW YAMHILL ST
Practice Address - Street 2:STE 345
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-1335
Practice Address - Country:US
Practice Address - Phone:503-267-4786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR53841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical