Provider Demographics
NPI:1649909516
Name:HALL, RICHARD JARETT (LPC-MHSP-TEMPORARY)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:JARETT
Last Name:HALL
Suffix:
Gender:M
Credentials:LPC-MHSP-TEMPORARY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 HURRICANE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4553
Mailing Address - Country:US
Mailing Address - Phone:407-496-1465
Mailing Address - Fax:
Practice Address - Street 1:1300 E 23RD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-5701
Practice Address - Country:US
Practice Address - Phone:423-760-4000
Practice Address - Fax:423-760-4051
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5637101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health