Heath B Walters, PH.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW28575 Issued in ID

Practice address

504 Main St Ste 470
Lewiston, ID 83501-1806

Phone

(208) 413-6711

NPI assigned

Jun 16, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1043660343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 MAIN ST STE 470",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011806",
            "telephone_number": "208-413-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 MAIN ST STE 470",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011806",
            "telephone_number": "208-413-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "HEATH",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00009000",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW28575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Alan Wales, MD, FACC
• Walgreen Co (Walgreens #02679)
• Walgreen Co (Rite Aid #16585)
• Walgreens
• Walla Walla Vamc
• Debbie Roxanne Ward, PT
• Michael F Ward, PT
• Esther Warnock, LMT
• Neil Bendle Washington, D.P.M
• Alex Benton Watson, MD

• Clinical Social Worker in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.