Individual provider Active NPI

Hallie Ann McLeod, MA

  • Clinical Psychologist
  • Fairmont, WV
National Provider Identifier
1699945402
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
756 Issued in WV
Practice address
1907 Constitution Drive
Fairmont, WV 26554
Phone
(304) 669-6408
Fax
(304) 636-9243
NPI assigned
Mar 7, 2008
Last updated
May 8, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 94-306 WV
Professional Counselor 101YP2500X 1363 WV
Clinical Psychologist 103TC0700X 756 WV Primary

Addresses

Primary practice location

1907 Constitution Drive
Fairmont, WV 26554

Mailing address

1907 Constitution Drive
Fairmont, WV 26554
Phone (304) 669-6408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20130322000388 WV Practitioner - Clinical Psychologist 8123078631 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1907 Constitution Dr
Fairmont, WV 26554-8527
Phone (304) 669-6408

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
94-306WVMDAddiction (Substance Use Disorder) Counselor
756WVMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Community Health Center CurrentSince Nov 1, 2009 Accepting new patients
Appalachian Community Health Center CurrentSince Nov 1, 2009 Accepting new patients
Chiron Psychotherapy PLLC CurrentSince Apr 1, 2015 Accepting new patients
Appalachian Community Health Center Past Accepting new patients

Locations

27 S Kanawha St
Buckhannon, WV 26201
Phone (304) 472-2022

725 Yokum St
Elkins, WV 26241
Phone (304) 636-3232

21 Middletown Rd
White Hall, WV 26554
Phone (304) 669-6408

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431043200000",
    "number": "1699945402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 CONSTITUTION DRIVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "26554",
            "telephone_number": "304-669-6408",
            "fax_number": "304-636-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 CONSTITUTION DRIVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "26554",
            "telephone_number": "304-669-6408",
            "fax_number": "304-636-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "HALLIE",
        "middle_name": "ANN",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-07",
        "last_updated": "2015-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WV",
            "license": "94-306",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "1363",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

Verify at the official NPI Registry.