Myron Stacy Hall, LPC
Individual provider Active NPI Professional Counselor · Lawndale, NC
NPI 1164568325 · NPPES record last updated Jul 9, 2007
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
- NPI
- 1164568325
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 4999 (NC)
- Practice address
- 577 Oak Grove Clover Hill Church Rd
Lawndale, NC 28090-9693 - Phone
- (704) 312-3922
- NPI assigned
- Jan 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4999 | NC | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4999 | NC | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6102865 | Medicaid | NC |
Other providers in Lawndale, NC
- Gaston Family Health Services, Inc
- Gaston Family Health Services, Inc.
- Gaston Family Health Services, Inc.
- Golden Years Rest Home
- Gordons Family Care Home
- Linda Ramsey Howard
- Denise Williams James
- Katrina W Angel
- Lean'S Family Care Home
- David R McDowell Jr.
All providers in Lawndale, NC · Professional Counselor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- OIG LEIE (HHS Office of Inspector General).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.