Waller, Kevin

Waller, Kevin is an individual health care provider with primary practice located at 363 Graphite Rd , Old Fort NC 28762-9455. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Waller, Kevin can be contacted via phone (828) 668-7590.

Contact Information

Primary practice address
363 Graphite Rd Old Fort NC 28762-9455
Phone: (828) 668-7590
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 20998 North Carolina
Behavioral Health & Social Service Providers / Mental Health 101YM0800X S7822 North Carolina
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 3145 North Carolina

Profile Details

NPI number 1023596244
LBN Legal business name Waller, Kevin
Credentials LPCS, LCAS, CCS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2018
Last updated Jul 31st, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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