Lori L Hall, MSW LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149009753 Issued in IL

Practice address

2100 Church St Ste 202
East Troy, WI 53120-1304

Phone

(561) 319-1580

NPI assigned

Oct 20, 2006

Last updated

Sep 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694822400000",
    "number": "1750463451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1090",
            "address_2": "PMB# 170",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "54548",
            "telephone_number": "561-319-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CHURCH ST STE 202",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531201304",
            "telephone_number": "561-319-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "LORI",
        "middle_name": "L",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2023-09-16",
        "certification_date": "2023-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "149009753",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13728",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1750463451",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Marie Eaton, RN BSN
• Family Medicine & Surgery LLC
• Megan Ferlindes, PT, DPT
• Lauren Christen Fleming
• Kimberly Ann Gottsacker, PTA
• Callie Lee Hastings, LPN
• Jennifer Lynn Hotz, RN
• Leah Mary Hudson, OTR
• Sandra Marie Huenink, OD
• Trisha A Ide, HS-BCP

• Clinical Social Worker in East Troy, WI
• Providers in East Troy, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.