Derreka J Walton, MSE LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4757-125 Issued in WI

Practice address

806 Valley Rd Ste 13
Menasha, WI 54952-1012

Phone

(920) 872-7292

Fax

(920) 872-7066

NPI assigned

Feb 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Couch Counseling Center, LLC

  • Mental Health Counselor
  • Menasha, WI
  • NPI 1467025965
  NPD Authorized official

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1104418318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 VALLEY RD STE 13",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521012",
            "telephone_number": "920-872-7292",
            "fax_number": "920-872-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 VALLEY RD STE 13",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521012",
            "telephone_number": "920-872-7292",
            "fax_number": "920-872-7066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1232 Stillmeadow Ln",
            "address_purpose": "LOCATION",
            "city": "Menasha",
            "state": "WI",
            "postal_code": "549528920",
            "country_code": "US",
            "telephone_number": "920-215-1556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTON",
        "first_name": "DERREKA",
        "middle_name": "J",
        "credential": "MSE LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4757-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vernon a. Larsen D.D.S., S.C.
• Kody Voung, PTA
• Deborah A Wagner, LCSW
• Walgreen Co
• Hannah Walther
• Rebecca Wanserski, OTR
• Stephen Ware, MSW
• Adam J Weber, OT
• Bradley James Welsing
• Michelle Wenzel, OTR

• Mental Health Counselor in Menasha, WI
• Providers in Menasha, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.