Provider Demographics
NPI:1487260246
Name:HALL, MELISSA RAE (LPC, LAC, MFTC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:RAE
Last Name:HALL
Suffix:
Gender:F
Credentials:LPC, LAC, MFTC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:RAE
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5740 N. CAREFREE CIRCLE
Mailing Address - Street 2:SUITE 120 BOX 394
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-1303
Mailing Address - Country:US
Mailing Address - Phone:719-318-3728
Mailing Address - Fax:
Practice Address - Street 1:5740 N CAREFREE CIR STE 120
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-2787
Practice Address - Country:US
Practice Address - Phone:719-318-3728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2022-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001538101YA0400X
COLPC.0016930101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)