Active NPI
Willa Hall, PH.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1639519580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 018908-1
- Practice address
- 928 Broadway
Suite 1206
New York, NY 10010-6008 - Phone
- (917) 509-1497
- NPI assigned
- Jun 25, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 018908-1 | NY | Primary |
Addresses
Primary practice location
928 Broadway
Suite 1206
New York, NY 10010-6008
Mailing address
588 Carroll St
Brooklyn, NY 11215-1118
Phone (917) 509-1497
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018908-1 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372118400000",
"number": "1639519580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "588 CARROLL ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112151118",
"telephone_number": "917-509-1497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "928 BROADWAY",
"address_2": "SUITE 1206",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100106008",
"telephone_number": "917-509-1497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "WILLA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-25",
"last_updated": "2013-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "018908-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.