Williametta Augusta Hall, BS, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

305143 Issued in MN

Practice address

6058 Highway 10 NW
Anoka, MN 55303-4530

Phone

(763) 421-5590

NPI assigned

Oct 28, 2019

Last updated

Oct 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

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

• Pelime Recovery Services, LLC

  dba Pelime Recovery Services

  • Addiction (Substance Use Disorder) Counselor
  • Champlin, MN
  • NPI 1134015720
  NPD Authorized official

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1174166672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6058 HIGHWAY 10 NW",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553034530",
            "telephone_number": "763-421-5590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3833 Coon Rapids Blvd NW Ste 260",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554332597",
            "country_code": "US",
            "telephone_number": "763-285-7109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "WILLIAMETTA",
        "middle_name": "AUGUSTA",
        "credential": "BS, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Group Health, Inc. (HealthPartners Riverway Pain Clinic)
• Jasmyne Star Gustafson
• Mariah Hackley
• Amy Marie Hagen, P.T.
• Elizabeth Anna Haider
• Sarah Elisabeth Haller, MA
• Colleen Elizabeth Halligan, DDS
• Whitney Leigh Hansen, MS-CCC-SLP
• Mark J. Harrington, D.D.S.
• Cynthia Harris, RN

• Addiction (Substance Use Disorder) Counselor in Anoka, MN
• Providers in Anoka, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.