Provider Demographics
NPI:1114420981
Name:WALTERS, KAREN B (MA, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:B
Last Name:WALTERS
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 HOCHBERG RD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1515
Mailing Address - Country:US
Mailing Address - Phone:724-672-7156
Mailing Address - Fax:
Practice Address - Street 1:310 CENTRAL CITY PLZ
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6441
Practice Address - Country:US
Practice Address - Phone:724-335-9883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA5087242101YS0200X
PAPC010345101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC010345OtherSTATE LICENSE