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Individual

KENESHA T HALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
8500 EXECUTIVE PARK AVE STE 200, FAIRFAX, VA 22031-2228
(703) 698-5220
(703) 573-2351
Mailing address
1891 EFFIE ST, LOS ANGELES, CA 90026-1711
(323) 644-2000

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
84064
CA
101YM0800X
Mental Health Counselor
84064
CA
104100000X
Social Worker
84064
CA
1041C0700X
Clinical Social Worker
Primary
107074
CA

Other

Enumeration date
09/11/2018
Last updated
01/18/2024
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