Max Walzer

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

495 Prosperity Lake Dr # 101
St Augustine, FL 32092-5045

Phone

(904) 370-3420

NPI assigned

Sep 18, 2023

Last updated

Jan 16, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Foundations Pediatrics Assessment and Treatment Center

  • Community/Behavioral Health Agency
  • St Augustine, FL
  • NPI 1841649241
  NPD

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1285412551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 TIERRA CV",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322591204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 PROSPERITY LAKE DR # 101",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320925045",
            "telephone_number": "904-370-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALZER",
        "first_name": "MAX",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-18",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Wall, D.D.S.
• Karen Wallace
• Heather Waller
• Allison Lenore Walsh, BA
• Kathryn Elise Walton
• Xiao Bo Wang, OTR/L
• Harry Waranch, L.M.T.
• Ward Medical Services
• Christine Marie Ward, FNP-BC
• Hayley Michelle Ward, ARNP

• Mental Health Counselor in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.