Walters, Donald A

Walters, Donald A is an individual health care provider with primary practice located at 1244 Wisconsin Ave Suite 303, Racine WI 53403-1987. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Walters, Donald A can be contacted via phone (262) 635-5520.

Contact Information

Primary practice address
1244 Wisconsin Ave Suite 303 Racine WI 53403-1987
Fax: (262) 635-5530
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 423-123 Wisconsin

Profile Details

NPI number 1417944216
LBN Legal business name Walters, Donald A
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Jul 8th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1417944216 NPPES
Wisconsin MEDICAID 39548600

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