Provider Demographics
NPI:1992063499
Name:HALL, CAROLYN OWENS (LMSW)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:OWENS
Last Name:HALL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2213 GOLDEN SAILS DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6607
Mailing Address - Country:US
Mailing Address - Phone:832-978-5813
Mailing Address - Fax:
Practice Address - Street 1:2213 GOLDEN SAILS DR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-6607
Practice Address - Country:US
Practice Address - Phone:832-978-5813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX555421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical