Walters, Carole Lynn
Walters, Carole Lynn is an sole proprietor health care provider with primary practice located at 959 Wealthy St Se , Grand Rapids MI 49506-2519. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Walters, Carole Lynn can be contacted via phone (616) 451-9650.Contact Information
Primary practice address
959 Wealthy St Se
Grand Rapids MI 49506-2519
Phone: (616) 451-9650
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | L2395721 | Michigan |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | L2395721 | Michigan |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | L2395721 | Michigan |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | L2395721 | Michigan |
Profile Details
| NPI number | 1023358314 |
|---|---|
| LBN Legal business name | Walters, Carole Lynn |
| Credentials | LMSW, BFA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 22nd, 2013 |
| Last updated | Feb 12th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023358314 | NPPES |
| Michigan | MEDICAID | 1376866160 |
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