Provider Demographics
NPI:1225878135
Name:HALL, AUSTIN THOMAS (LSW)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:THOMAS
Last Name:HALL
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47170-1637
Mailing Address - Country:US
Mailing Address - Phone:812-752-2837
Mailing Address - Fax:
Practice Address - Street 1:75 N 1ST ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-1637
Practice Address - Country:US
Practice Address - Phone:812-752-2837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health