Trevor Allen Hall, PSYD, ABPDN

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2540 Issued in OR

Practice address

707 SW Gaines St
Portland, OR 97239-2901

Phone

(503) 418-2134

NPI assigned

Dec 4, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thallmd10074@direct.ohsu.edu

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.

• University Professional Services

  • General Practice Physician
  • Portland, OR
  • NPI 1376709535
  Medicare reassignment NPD
• Northwest Neurobehavioral Health PLLC

  • Clinical Psychologist
  • Boise, ID
  • NPI 1518102797
  NPD (past) Authorized official
• University Professional Services

  • Pharmacy
  • Beaverton, OR
  • NPI 1073054714
  NPD
• University Professional Services

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1750753687
  NPD
• Northwest Neurobehavioral Health, LLC

  • Clinical Social Worker
  • Meridian, ID
  • NPI 1013223445
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1306914643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 SW GAINES ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392901",
            "telephone_number": "503-418-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SW GAINES ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392901",
            "telephone_number": "503-418-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "TREVOR",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "PSYD, ABPDN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1804",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY202444",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1518102797",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean D. Hall, BCABA
• Stephen Blakeslee Hall, MD
• Suzanne M Hall, MD
• Taylor Hall
• Teri Rae Hall, MS
• Samantha Renee Sheffels Halladin, MD
• Kylie Halland
• Staci Noelle Hallanzzini, LCSW
• Keara Hallberg
• Susan Haller

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.