Waller Psychotherapy, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

WALLER PSYCHOTHERAPY, LLC

Practice address

11007 Sweet Apple CT
Upper Marlboro, MD 20772-7103

Phone

(703) 675-7378

NPI assigned

Sep 3, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Troy A Waller Sr., EDD, LPC

Title

Owner/Director

Phone

(703) 675-7378

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1326652702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11007 SWEET APPLE CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207727103",
            "telephone_number": "703-675-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11007 SWEET APPLE CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207727103",
            "telephone_number": "703-675-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLER PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "703-675-7378",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "EDD, LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co.
• Wanda Charlene Walker Hodges, CRNA
• Kimberly Lynn Walker, LCSW-C
• Mariona Walker, CSA
• Catherine Walsh
• Bleck Che Roy Wandji
• Jacqueline Warah
• Brittany Ward, LCSW-C
• Danielle Ward

• Community/Behavioral Health Agency in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.