Provider Demographics
NPI:1508322314
Name:WALTON, LAURA E (LCMHC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:E
Last Name:WALTON
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-2918
Mailing Address - Country:US
Mailing Address - Phone:919-475-3349
Mailing Address - Fax:
Practice Address - Street 1:2726 CROASDAILE DR STE 209
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2590
Practice Address - Country:US
Practice Address - Phone:919-283-9116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-17
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14583101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor