Jimmie L Hall, MSW

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CSA0185301 Issued in NM

Practice address

Pinon and Cottonwood Drive BLDG 2301
Shiprock, NM 87420-1830

Phone

(505) 368-1438

Fax

(505) 368-1452

NPI assigned

Nov 30, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1508168329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1830",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874201830",
            "telephone_number": "505-368-1438",
            "fax_number": "505-368-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PINON AND COTTONWOOD DRIVE BLDG 2301",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874201830",
            "telephone_number": "505-368-1438",
            "fax_number": "505-368-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JIMMIE",
        "middle_name": "L",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-30",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CSA0185301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Boyd Girouard, CRNA, MSN
• M Martia Glass, MD
• Suzannah Miriam Gould, LADAC
• Clinton Kyle Gropp, PHARM D
• Sarah Halimi, OD
• Wendy V. Hall, RN
• Daniel N Hamil, PHARMD
• Kelly Hamilton
• Walter Patrick Haney, MD
• Ciara Hansen, PHD

• Addiction (Substance Use Disorder) Counselor in Shiprock, NM
• Providers in Shiprock, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.