Provider Demographics
NPI:1861670044
Name:WALSTON, ARTHUR DAVID (CASAC, LMSW)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:DAVID
Last Name:WALSTON
Suffix:
Gender:M
Credentials:CASAC, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 VISTA CT
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-5005
Mailing Address - Country:US
Mailing Address - Phone:631-276-3612
Mailing Address - Fax:
Practice Address - Street 1:116 VISTA CT
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-5005
Practice Address - Country:US
Practice Address - Phone:631-276-3612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-09
Last Update Date:2014-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)