Individual provider Active NPI

Tiffany Cherie Hall, RADT

  • Addiction (Substance Use Disorder) Counselor
  • Eureka, CA
National Provider Identifier
1538784707
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R1389940520 Issued in CA
Practice address
1219 10TH St
Eureka, CA 95501-2024
Phone
(707) 443-0514
Fax
(707) 442-1191
NPI assigned
Jun 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1389940520 CA Primary

Addresses

Primary practice location

1219 10TH St
Eureka, CA 95501-2024

Mailing address

PO Box 6310
Eureka, CA 95502-6310
Phone (707) 443-4237

Other practice location 1

1303 11th St
Eureka, CA 95501-2028
Phone (707) 444-6262

Other practice location 2

944 N St
Eureka, CA 95501-2045
Phone (707) 443-0514

Other practice location 3

905 L St
Eureka, CA 95501-1943
Phone (707) 444-2033

Other practice location 4

1116 9th St
Eureka, CA 95501-1936
Phone (707) 442-2033

Other practice location 5

1120 9th St
Eureka, CA 95501-1936
Phone (707) 444-2033

Other practice location 6

1024 N St
Eureka, CA 95501-2047
Phone (707) 269-9566

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R1389940520CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Humboldt Recovery Center Inc., PastSince Jun 14, 2020 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1538784707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6310",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955026310",
            "telephone_number": "707-443-4237",
            "fax_number": "707-442-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 10TH ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955012024",
            "telephone_number": "707-443-0514",
            "fax_number": "707-442-1191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1303 11th St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955012028",
            "country_code": "US",
            "telephone_number": "707-444-6262",
            "fax_number": "707-442-1191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "944 N St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955012045",
            "country_code": "US",
            "telephone_number": "707-443-0514",
            "fax_number": "707-442-1191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 L St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955011943",
            "country_code": "US",
            "telephone_number": "707-444-2033",
            "fax_number": "707-442-1191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1116 9th St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955011936",
            "country_code": "US",
            "telephone_number": "707-442-2033",
            "fax_number": "707-442-1191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 9th St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955011936",
            "country_code": "US",
            "telephone_number": "707-444-2033",
            "fax_number": "707-442-1191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1024 N St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955012047",
            "country_code": "US",
            "telephone_number": "707-269-9566",
            "fax_number": "707-442-1191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "TIFFANY",
        "middle_name": "CHERIE",
        "credential": "RADT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1389940520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.