| Shamika Hall, Ph.d. & Associates, Pllc | |
|
7901 S. 12th St. Suite 201 Portage MI 49024 | |
| (269) 588-0750 | |
| (269) 324-5822 |
| Full Name | Shamika Hall, Ph.d. & Associates, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 7901 S. 12th St., Portage, Michigan |
| Authorized Official Name and Position | Shamika Yoionde Hall (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 2695880750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shamika Hall, Ph.d. & Associates, Pllc 7901 S. 12th St. Suite 201 Portage MI 49024 Ph: (269) 588-0750 | Shamika Hall, Ph.d. & Associates, Pllc 7901 S. 12th St. Suite 201 Portage MI 49024 Ph: (269) 588-0750 |
| NPI Number | 1942593744 |
|---|---|
| Provider Enumeration Date | 05/26/2011 |
| Last Update Date | 03/16/2015 |
| Medicare PECOS PAC ID | 3779800941 |
|---|---|
| Medicare Enrollment ID | O20150327000353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942593744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301014087 (Michigan) | Primary |
| 251S00000X | Community/behavioral Health | 6301014087 (Michigan) | Secondary |
| Provider Name | Shamika Y Hall |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912209156 PECOS PAC ID: 4082882667 Enrollment ID: I20110726000715 |
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