Individual provider Active NPI

Jon Christopher Hall, PH.D., LCSW

  • Counselor
  • Wilmington, NC
National Provider Identifier
1720250467
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C005936 Issued in NC
Practice address
321 N Front St
Wilmington, NC 28401-3908
Phone
(910) 795-6677
NPI assigned
Apr 1, 2008
Last updated
Sep 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C005936 NC Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X C005936 NC
Mental Health Counselor 101YM0800X C005936 NC
Professional Counselor 101YP2500X C005936 NC
School Counselor 101YS0200X C005936 NC
Clinical Social Worker 1041C0700X C005936 NC
School Social Worker 1041S0200X C005936 NC
Marriage & Family Therapist 106H00000X C005936 NC
Psychoanalyst 102L00000X C005936 NC

Addresses

Primary practice location

321 N Front St
Wilmington, NC 28401-3908

Mailing address

9404 Voyagers Way
Wilmington, NC 28412-3442
Phone (910) 795-6677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20150727002614 NC Practitioner - Clinical Social Worker 4284948829 Practice locations: Wilmington, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5006 Randall Pkwy
Wilmington, NC 28403-2829
Phone (910) 795-6677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
C005936NCMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Therapist Wilmington Counselor Past Accepting new patients
The Wilmington Center PLLC Counselor Past Accepting new patients

Organizations & group practices 2

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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1720250467",
    "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": "321 N FRONT ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284013908",
            "telephone_number": "910-795-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JON",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-01",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "C005936",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "C005936",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NC",
            "license": "C005936",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.