Provider Demographics
NPI:1629218342
Name:ALTON, WALTER L (MA, LPC, BCPC)
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:L
Last Name:ALTON
Suffix:
Gender:M
Credentials:MA, LPC, BCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 SHILOH RD NW
Mailing Address - Street 2:SUITE 2770
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-7198
Mailing Address - Country:US
Mailing Address - Phone:770-262-2743
Mailing Address - Fax:
Practice Address - Street 1:1275 SHILOH RD NW
Practice Address - Street 2:SUITE 2770
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7198
Practice Address - Country:US
Practice Address - Phone:770-262-2743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-21
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004713101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional