Walter C Buboltz Jr., PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

870 Issued in LA

Practice address

622 Burgessville Rd
Ruston, LA 71270-5154

Phone

(318) 224-7223

Fax

(318) 415-1004

NPI assigned

Jul 15, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Thinktrek LLC

  • Professional Counselor
  • Ruston, LA
  • NPI 1215415229

  LA

  Medicare reassignment NPD
• Buboltz & Associates, LLC

  • Counseling Psychologist
  • Ruston, LA
  • NPI 1720469570

  Counseling

  NPD (past) Authorized official
• Milestones ABA Center

  • Behavior Analyst
  • Ruston, LA
  • NPI 1861163669
  NPD

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1235570573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 WALNUT AVE",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705145",
            "telephone_number": "318-512-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 BURGESSVILLE RD",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705154",
            "telephone_number": "318-224-7223",
            "fax_number": "318-415-1004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2909 N Trenton St",
            "address_purpose": "LOCATION",
            "city": "Ruston",
            "state": "LA",
            "postal_code": "712702443",
            "country_code": "US",
            "telephone_number": "318-224-7223",
            "fax_number": "318-415-1004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUBOLTZ",
        "first_name": "WALTER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-15",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "LA",
            "license": "870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3823004",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melinda F Bryan, PH.D., CCC-A
• Clay Dean Bryant
• Crystal Renee Bryant
• Jasmine Bryant
• Buboltz & Associates, LLC
• Buddy Drivers LLC
• Buddy Drivers LLC
• Bonnie Lejeune Buller, L.C.S.W.
• Stephanie Bundle
• David Michael Burkhalter

• All providers in Ruston, LA
• Counseling Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.