Active NPI
Walter Lee Doty IV, MS
- Mental Health Counselor
- Council Bluffs, IA
National Provider Identifier
1376978403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 001625
- Practice address
- 3103 8TH Ave
Council Bluffs, IA 51501-5714 - Phone
- (402) 290-8537
- NPI assigned
- Sep 9, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 001625 | IA | Primary |
Addresses
Primary practice location
3103 8TH Ave
Council Bluffs, IA 51501-5714
Mailing address
3103 8TH Ave
Council Bluffs, IA 51501-5714
Phone (402) 290-8537
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001625 | IA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378684800000",
"number": "1376978403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3103 8TH AVE",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515015714",
"telephone_number": "402-290-8537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3103 8TH AVE",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515015714",
"telephone_number": "402-290-8537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOTY",
"first_name": "WALTER",
"middle_name": "LEE",
"name_prefix": "Mr.",
"name_suffix": "IV",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-09",
"last_updated": "2013-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "001625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.