Individual provider Active NPI

Diandra Danielle Hall, BA, MA, LPC

  • Professional Counselor
  • Swansea, IL
National Provider Identifier
1003625708
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.019289 Issued in IL
Practice address
209 W Pointe Dr Ste D
Swansea, IL 62226-8310
Phone
(618) 641-3588
Fax
(618) 671-6503
NPI assigned
Jan 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.019289 IL Primary

Addresses

Primary practice location

209 W Pointe Dr Ste D
Swansea, IL 62226-8310

Mailing address

209 W Pointe Dr Ste D
Swansea, IL 62226-8310
Phone (618) 641-3588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

112 Autumn Pine Dr
Apt 2
Fairview Heights, IL 62208-2944

209 W Pointe Dr
Suite D
Swansea, IL 62226-8310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts, Master of Arts

State licenses

LicenseStateTypeSpecialty
178.019289ILMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1003625708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W POINTE DR STE D",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622268310",
            "telephone_number": "618-641-3588",
            "fax_number": "618-671-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W POINTE DR STE D",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622268310",
            "telephone_number": "618-641-3588",
            "fax_number": "618-671-6503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "DIANDRA",
        "middle_name": "DANIELLE",
        "credential": "BA, MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.019289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swansea, IL

Sources for this page

Verify at the official NPI Registry.