Provider Demographics
NPI:1285843102
Name:WALTERS, DENISE MARIE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:MARIE
Last Name:WALTERS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-3224
Mailing Address - Country:US
Mailing Address - Phone:508-277-8016
Mailing Address - Fax:
Practice Address - Street 1:26 VALLEY RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-6401
Practice Address - Country:US
Practice Address - Phone:401-848-6363
Practice Address - Fax:401-848-6389
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
RIMHC00582101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health