Provider Demographics
NPI:1992035612
Name:HALL, CAROLINE B (PHD, LCSW)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:B
Last Name:HALL
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3113 9TH ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-2024
Mailing Address - Country:US
Mailing Address - Phone:703-812-0963
Mailing Address - Fax:
Practice Address - Street 1:3800 RESERVOIR RD NW
Practice Address - Street 2:5TH FLOOR, KOBER COGAN BUILDING
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2113
Practice Address - Country:US
Practice Address - Phone:202-784-0682
Practice Address - Fax:202-687-8577
Is Sole Proprietor?:No
Enumeration Date:2009-12-31
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3024452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC204010ZATQMedicare PIN