Individual
MR. JEROME HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LCAS-A
Contact information
Practice address
7223 DOVE FIELD DR, FORT MILL, SC 29707-7846
(803) 431-7100
(843) 456-0263
Mailing address
7223 DOVE FIELD DR, FORT MILL, SC 29707-7846
(704) 771-2976
(843) 456-2063
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3081-A
NC
1041C0700X
Clinical Social Worker
9639
SC
1041C0700X
Clinical Social Worker
Primary
C010289
NC
Other
Enumeration date
03/23/2013
Last updated
08/23/2022
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