Provider Demographics
NPI:1053067959
Name:WALTON, HEDLUN (LPC)
Entity Type:Individual
Prefix:MR
First Name:HEDLUN
Middle Name:
Last Name:WALTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1886 SHADYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3827
Mailing Address - Country:US
Mailing Address - Phone:517-614-1532
Mailing Address - Fax:
Practice Address - Street 1:1886 SHADYWOOD LN
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3827
Practice Address - Country:US
Practice Address - Phone:517-614-1532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007743101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor