Provider Demographics
NPI:1649160243
Name:HALL, ELAINE (LISW-CP)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 NARCISSUS LN
Mailing Address - Street 2:
Mailing Address - City:PORT ROYAL
Mailing Address - State:SC
Mailing Address - Zip Code:29935-1605
Mailing Address - Country:US
Mailing Address - Phone:309-750-1602
Mailing Address - Fax:
Practice Address - Street 1:1555 FORDING ISLAND RD
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-1175
Practice Address - Country:US
Practice Address - Phone:843-815-6789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC145811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical