Active NPI
Myron Stacy Hall, LPC
- Professional Counselor
- Lawndale, NC
National Provider Identifier
1164568325
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Dec 18, 2014.
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4999
- Practice address
- 577 Oak Grove Clover Hill Church Rd
Lawndale, NC 28090-9693 - Phone
- (704) 312-3922
- NPI assigned
- Jan 29, 2007
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4999 | NC | Primary |
Addresses
Primary practice location
577 Oak Grove Clover Hill Church Rd
Lawndale, NC 28090-9693
Mailing address
577 Oak Grove Clover Hill Church Rd
Lawndale, NC 28090-9693
Phone (704) 312-3922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6102865 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4999 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1164568325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "577 OAK GROVE CLOVER HILL CHURCH RD",
"city": "LAWNDALE",
"state": "NC",
"postal_code": "280909693",
"telephone_number": "704-312-3922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "577 OAK GROVE CLOVER HILL CHURCH RD",
"city": "LAWNDALE",
"state": "NC",
"postal_code": "280909693",
"telephone_number": "704-312-3922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "MYRON",
"middle_name": "STACY",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-29",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "4999",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6102865",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawndale, NC
- Gaston Family Health Services, Inc (Kintegra at Burns High)
- Gaston Family Health Services, Inc. (Kintegra Family Medicine - Fallston)
- Gaston Family Health Services, Inc. (Kintegra at Burns Middle)
- Golden Years Rest Home
- Gordons Family Care Home
- Linda Ramsey Howard
- Denise Williams James, HAIR LOSS SPECIALIST
- Katrina W Angel (Morning Star Family Care)
- Lean's Family Care Home
- David R McDowell Jr., ANP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.