Provider Demographics
NPI:1114235678
Name:WALTON, KATHERINE J (LPCC-S, MED)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:J
Last Name:WALTON
Suffix:
Gender:F
Credentials:LPCC-S, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13543 BEVELHYMER RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-9651
Mailing Address - Country:US
Mailing Address - Phone:740-972-4792
Mailing Address - Fax:
Practice Address - Street 1:665 E DUBLIN GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3245
Practice Address - Country:US
Practice Address - Phone:614-396-7056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-18
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0900576101YP2500X
OHC.0900576101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty