Organization Active NPI

Sandra Bunch Walton

Doing business as Life Quest

  • Adult Mental Health Clinic/Center
  • Greenville, NC
National Provider Identifier
1235127572
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
SANDRA BUNCH WALTON
Doing business as
Life Quest
Practice address
1990 Allen Rd
Suite B
Greenville, NC 27834-0058
Phone
(252) 758-4554
Fax
(252) 758-5561
NPI assigned
Oct 11, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sandra Bunch Walton, LMFT, CNSNPI 1093703324
Title
Owner/Provider
Phone
(252) 758-4554

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NC Primary

Addresses

Primary practice location

1990 Allen Rd
Suite B
Greenville, NC 27834-0058

Mailing address

1990 Allen Rd
Suite B
Greenville, NC 27834-0058
Phone (252) 758-4554

Other identifiers 1

IdentifierTypeStateIssuer
126AMOtherNCBCBS

Other names 1

  • Life Quest Doing business as

National Provider Directory

National Provider Directory

Locations

1990 Allen Rd
Ste B
Greenville, NC 27834
Phone (252) 758-4554

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235127572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 ALLEN RD",
            "address_2": "SUITE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278340058",
            "telephone_number": "252-758-4554",
            "fax_number": "252-758-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 ALLEN RD",
            "address_2": "SUITE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278340058",
            "telephone_number": "252-758-4554",
            "fax_number": "252-758-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA BUNCH WALTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "BUNCH",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "252-758-4554",
        "authorized_official_credential": "LMFT, CNS"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "126AM",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Quest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.