Provider Demographics
NPI:1689798977
Name:HALL, CHRISTINA V (LICSW, LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:V
Last Name:HALL
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61304
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20859-1304
Mailing Address - Country:US
Mailing Address - Phone:202-494-9593
Mailing Address - Fax:
Practice Address - Street 1:5335 WISCONSIN AVE NW STE 440
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2079
Practice Address - Country:US
Practice Address - Phone:202-494-9593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD112151041C0700X
DCLC3036491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD491039Medicare ID - Type Unspecified
MDF3650001Medicare UPIN
DCF3650001Medicare UPIN
DC491039Medicare ID - Type Unspecified