Active NPI
Bonnetta Hall
- Professional Counselor
- Charleston, SC
National Provider Identifier
1225513203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 8611
- Practice address
- 2100 Charlie Hall Blvd
Charleston, SC 29407 - Phone
- (843) 852-4100
- NPI assigned
- Sep 26, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 8611 | SC | Primary |
Addresses
Primary practice location
2100 Charlie Hall Blvd
Charleston, SC 29407
Mailing address
2100 Charlie Hall Blvd
Charleston, SC 29414-5832
Phone (843) 852-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760596480 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center of Hope of Myrtle Beach, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Lifestance Health
- Mental Health Counselor
- Mount Pleasant, SC
- NPI 1316375678
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Myrtle Beach, SC
- NPI 1720302144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699574400000",
"number": "1225513203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 CHARLIE HALL BLVD",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294145832",
"telephone_number": "843-852-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 CHARLIE HALL BLVD",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29407",
"telephone_number": "843-852-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "BONNETTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-26",
"last_updated": "2023-11-10",
"certification_date": "2023-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "8611",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1760596480",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.