BREDA FAYE HALL (NPI# 1063684637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063684637 |
| Entity Type | Individual |
| Full Name | BREDA FAYE HALL |
| Other Name | BREDA FAYE INMAN |
| Credential | LPCC |
| Practice Address |
1531 Highland Colony Pkwy Madison MS 39110-7469 |
| Mailing Address |
Po Box 1643 Brandon MS 39043-1643 |
| Practice Telephone | 6015061459 |
| Mailing Telephone | 6019511583 |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2008-12-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
0083571 | NM | Behavioral Health & Social Service Providers |
| N | 101YP1600X |
Counselor Specialization: Pastoral |
0083571 | NM | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
0083571 | NM | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | DEPT. OF TREASURY, IRS | 01-0877337 | 01 |
| Street Address |
1531 HIGHLAND COLONY PKWY |
| City | MADISON |
| State | MS |
| Zip Code | 39110-7469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568943025 | Mary Nicole Thomason | Behavioral Analyst | 1531 Highland Colony Pkwy, Madison, MS 39110-7469 | 2018-08-23 |
| 1891288718 | Madeline Jean Potter | Behavioral Analyst | 1531 Highland Colony Pkwy, Madison, MS 39110-7469 | 2018-06-14 |
| 1821545823 | Sarah Ann Kowalczyk | Behavioral Analyst | 1531 Highland Colony Pkwy, Madison, MS 39110-7469 | 2016-09-07 |
| 1710332796 | Charmaine Bolden | Behavioral Analyst | 1531 Highland Colony Pkwy, Madison, MS 39110-7469 | 2016-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134784689 | Therapy South - Gluckstadt LLC | Physical Therapist | 1716 Us 51, Ste N, Madison, MS 39110 | 2019-05-09 |
| 1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
| 1912488198 | Madison Medical Compounding Pharmacy | Pharmacy | 111 Fountains Blvd. Building B Ste. A, Madison, MS 39110 | 2018-08-24 |
| 1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
| 1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
| 1093227589 | Hannah Monk Hawthorne | Counselor | 930 Ebenezer Blvd., Suite D, Madisin, MS 39110 | 2017-10-25 |
| 1548786650 | Kimberly Allen | Pharmacist | 1100 Us- 51, Madison, MS 39110 | 2017-08-21 |
| 1891218186 | Delta Elizabeth Stark | Chiropractor | 1085 Gluckstadt Rd., Bld 300 Ste E, Madison, MS 39110 | 2017-07-19 |
| 1861914848 | Laura Hartlein | Dietitian, Registered | 200 Park Circle Dr. #2, Flowood, MS 39110 | 2017-07-12 |
| 1831620608 | Ona Irby | Occupational Therapist | 105 Munich Dr, Madison, MS 39110 | 2017-03-23 |
| Find all providers in zip 39110 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710591086 | Carrie Allen | Counselor | 222 Kyser Blvd Apt 73, Madison, AL 35758-2307 | 2020-09-03 |
| 1548872765 | Kelly Kendricks | Counselor | 2002 Atwood Ave Ste 225, Madison, WI 53704-5382 | 2020-08-19 |
| 1740803097 | Megan Gour | Counselor | 8102 Wellness Way, Madison, WI 53719-8800 | 2020-05-21 |
| 1578197141 | Nicole Danielle Morra | Counselor | 141 Durham Rd Ste 19, Madison, CT 06443-2657 | 2020-02-23 |
| 1982236741 | Jolin Mitchel | Counselor | 437 S Yellowstone Dr Ste 219, Madison, WI 53719-1061 | 2020-02-10 |
| 1346880127 | Tree of Life Treatment Services | Counselor | 437 S Yellowstone Dr Ste 200, Madison, WI 53719-2902 | 2020-01-09 |
| 1720623226 | Reflections Mental Health LLC | Counselor | 2802 Coho St Ste 203, Madison, WI 53713-4521 | 2019-11-08 |
| 1740822287 | Diamond Jones | Counselor | 2093 W Us 90, Madison, FL 32340-4308 | 2019-10-16 |
| 1457819617 | Emma Coleen Tagariello | Counselor | 170 Ridgedale Ave, Madison, NJ 07940-1220 | 2019-03-06 |
| 1144785940 | Vallis LLC | Counselor | 814 Palmer Rd Ste B4, Madison, AL 35758-3185 | 2019-02-05 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.