Ezra Hall, PH.D., BCBA-D

Individual provider Active NPI Behavior Analyst · Martinsburg, WV

NPI 1265848451 · NPPES record last updated Jan 4, 2022

Key facts

NPI
1265848451
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
Practice address
1010 Winchester Ave
Martinsburg, WV 25401-1683
Phone
(304) 290-4262
Fax
(304) 212-0627
NPI assigned
Jul 8, 2014
Sex
Male
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain State Applied Behavior Analysis LLC Behavior Analyst Current
since Jan 17, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Yes

Addresses

Primary practice location

1010 Winchester Ave
Martinsburg, WV 25401-1683

Mailing address

PO Box 442
Shepherdstown, WV 25443-0442
Phone (304) 290-4262

Other providers in Martinsburg, WV

All providers in Martinsburg, WV · Behavior Analyst in West Virginia

Sources for this page

Verify at the official NPI Registry.