Provider Demographics
NPI:1518237841
Name:WALTON, JOSIE MARY (MA, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JOSIE
Middle Name:MARY
Last Name:WALTON
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7728 JAVELINA RD SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-5318
Mailing Address - Country:US
Mailing Address - Phone:505-263-8667
Mailing Address - Fax:505-839-9459
Practice Address - Street 1:7728 JAVELINA RD SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-5318
Practice Address - Country:US
Practice Address - Phone:505-263-8667
Practice Address - Fax:505-839-9459
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0139701101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health