Individual
MR. KEVIN A HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
205 PORTLAND ST, BOSTON, MA 02114-1721
(617) 523-2214
Mailing address
205 PORTLAND ST, BOSTON, MA 02114-1721
(617) 523-2214
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1021510
MA
1041C0700X
Clinical Social Worker
ISW01293
RI
Other
Enumeration date
01/21/2010
Last updated
12/20/2010
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