Provider Demographics
NPI:1851468235
Name:WALTER, PATRICIA L (MS, LMHC, NCAPS-III)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:L
Last Name:WALTER
Suffix:
Gender:F
Credentials:MS, LMHC, NCAPS-III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5209 CANTERBURY LANE
Mailing Address - Street 2:
Mailing Address - City:LOGANSPORT,
Mailing Address - State:IN
Mailing Address - Zip Code:46947
Mailing Address - Country:US
Mailing Address - Phone:574-739-0409
Mailing Address - Fax:
Practice Address - Street 1:6 CHASE PARK
Practice Address - Street 2:
Practice Address - City:LOGANSPORT,
Practice Address - State:IN
Practice Address - Zip Code:46947
Practice Address - Country:US
Practice Address - Phone:574-732-1166
Practice Address - Fax:574-735-4117
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22927101YA0400X
IN39000653A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health