Active NPI
Marcelle Idette Blair Hall, LCSW
- Social Worker
- Media, PA
National Provider Identifier
1225197684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW125167
- Practice address
- 205 N Monroe St
Media, PA 19063-3052 - Phone
- (610) 800-2475
- NPI assigned
- Dec 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW016320 | PA | |
| Clinical Social Worker | 1041C0700X | Q1-0001254 | DE | |
| Social Worker | 104100000X | SW125167 | PA | Primary |
Addresses
Primary practice location
205 N Monroe St
Media, PA 19063-3052
Mailing address
2150 Springhouse Holw
Garnet Valley, PA 19060-2116
Phone (610) 800-2475
Other names 1
- Ms. Marcelle Idette Banks-Blair
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW125167 | PA | MD | Social Worker |
| Q1-0001254 | DE | MD | Clinical Social Worker |
| CW016320 | PA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marvin Behavioral Health Ma PC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507680000000",
"number": "1225197684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2150 SPRINGHOUSE HOLW",
"city": "GARNET VALLEY",
"state": "PA",
"postal_code": "190602116",
"telephone_number": "610-800-2475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 N MONROE ST",
"city": "MEDIA",
"state": "PA",
"postal_code": "190633052",
"telephone_number": "610-800-2475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAIR HALL",
"first_name": "MARCELLE",
"middle_name": "IDETTE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-08",
"last_updated": "2017-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW016320",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DE",
"license": "Q1-0001254",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "SW125167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARCELLE",
"last_name": "BANKS-BLAIR",
"middle_name": "IDETTE",
"prefix": "MS.",
"credential": "LSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Media, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.