Therapist Wilmington

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C005936 Issued in NC

Legal business name

THERAPIST WILMINGTON

Practice address

9404 Voyagers Way
Wilmington, NC 28412-3442

Phone

(910) 795-6677

NPI assigned

Jul 17, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jon Christopher Hall, LCSW. PH.D.NPI 1720250467

Title

Owner/Operator

Phone

(910) 795-6677

Specialties & licenses 9

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jon Christopher Hall, PH.D., LCSW

  • Counselor
  • Wilmington, NC
  • NPI 1720250467
  NPD (past) Authorized official

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1497000319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9404 VOYAGERS WAY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284123442",
            "telephone_number": "910-795-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9404 VOYAGERS WAY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284123442",
            "telephone_number": "910-795-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPIST WILMINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "910-795-6677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCSW. PH.D."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005936",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "C005936",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.