Provider Demographics
NPI:1760030381
Name:WALTER, CAITLIN (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:WALTER
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7834 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-1744
Mailing Address - Country:US
Mailing Address - Phone:913-908-7530
Mailing Address - Fax:
Practice Address - Street 1:8575 W 110TH ST STE 320
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2774
Practice Address - Country:US
Practice Address - Phone:913-735-0130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03237101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health