Individual
MR. CORY JUSTIN HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT-S, LCDC
Contact information
Practice address
1219 E BROADWAY ST, SWEETWATER, TX 79556-4719
(325) 246-9121
Mailing address
1219 E BROADWAY ST, SWEETWATER, TX 79556-4719
(325) 246-9121
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
15146
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
15146
TX
106H00000X
Marriage & Family Therapist
Primary
203092
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4314676
—
TX
Enumeration date
04/24/2020
Last updated
11/07/2024
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