Provider Demographics
NPI:1083741870
Name:WALTON, ROBERT S (LMHP CPC LADC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:S
Last Name:WALTON
Suffix:
Gender:M
Credentials:LMHP CPC LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1352
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68702-1352
Mailing Address - Country:US
Mailing Address - Phone:402-841-3791
Mailing Address - Fax:
Practice Address - Street 1:125 S 4TH ST
Practice Address - Street 2:SUITE 212
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5200
Practice Address - Country:US
Practice Address - Phone:402-841-3791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE406101YA0400X
NE2323101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025012200Medicaid
NE84908OtherBLUE CROSS