Mia Yvette Hall, DMFT & LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW4023 Issued in FL

Practice address

121 N 2ND St
Suite301
Fort Pierce, FL 34950-4435

Phone

(772) 595-3773

Fax

(772) 464-0087

NPI assigned

Jan 10, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Uplift Behavioral Health PC

  • Adult Mental Health Clinic/Center
  • Bethesda, MD
  • NPI 1629740410

  FL

  Medicare reassignment

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1013211713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 NORT SECOND STREET",
            "address_2": "SUITE301",
            "city": "FT. PIERCE",
            "state": "FL",
            "postal_code": "34950",
            "telephone_number": "772-595-3773",
            "fax_number": "772-464-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N 2ND ST",
            "address_2": "SUITE301",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504435",
            "telephone_number": "772-595-3773",
            "fax_number": "772-464-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "MIA",
        "middle_name": "YVETTE",
        "name_prefix": "Dr.",
        "credential": "DMFT & LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW4023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael B Gyimah, MD
• Diana Marie Hafner, HIS
• Joshua Dennis Hagan, MD
• Jordan P Hagans, APRN
• Jessica Dawn Hagerman, B.S.
• Ria Hallenbeck, ARNP
• Stefanie Hallowell, MS, LPC
• David Halpern, DDS
• Alexa N Hamilton
• Angili Hamilton

• Clinical Social Worker in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.