Provider Demographics
NPI:1023472016
Name:HALL, ALISHA LYNN (LMSW, LCSW-P)
Entity type:Individual
Prefix:MS
First Name:ALISHA
Middle Name:LYNN
Last Name:HALL
Suffix:
Gender:F
Credentials:LMSW, LCSW-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 DORSETT CT
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-9000
Mailing Address - Country:US
Mailing Address - Phone:918-397-7688
Mailing Address - Fax:
Practice Address - Street 1:245 S MADISON BLVD
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2822
Practice Address - Country:US
Practice Address - Phone:918-336-1463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5451-P104100000X
OK6687-P101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker