Active NPI
Marshell Sunnatta Walters, IMF
- Mental Health Counselor
- Phoenix, AZ
National Provider Identifier
1205974664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 3125 W Durango St
Phoenix, AZ 85009-6217 - Phone
- (602) 372-7226
- NPI assigned
- Feb 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMF 52514 | CA | |
| Clinical Social Worker | 1041C0700X | IMF 52514 | CA | |
| Mental Health Counselor | 101YM0800X | AZ | Primary |
Addresses
Primary practice location
3125 W Durango St
Phoenix, AZ 85009-6217
Mailing address
3125 W Durango St
Phoenix, AZ 85009-6217
Phone (602) 372-7226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 52514 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222819200000",
"number": "1205974664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3125 W DURANGO ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850096217",
"telephone_number": "602-372-7226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3125 W DURANGO ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850096217",
"telephone_number": "602-372-7226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "MARSHELL",
"middle_name": "SUNNATTA",
"credential": "IMF",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-01",
"last_updated": "2008-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "IMF 52514",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "IMF 52514",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.