Provider Demographics
NPI:1487520912
Name:WALTON, CHRISLEIGH NICOLE
Entity type:Individual
Prefix:
First Name:CHRISLEIGH
Middle Name:NICOLE
Last Name:WALTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2651 COUNTY ROAD 4212
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77632-7074
Mailing Address - Country:US
Mailing Address - Phone:409-988-3044
Mailing Address - Fax:
Practice Address - Street 1:4749 ODOM RD
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-7080
Practice Address - Country:US
Practice Address - Phone:409-200-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100490101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional