Diana L. Walther, PH.D. PC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY002320 Issued in GA

Legal business name

DIANA L. WALTHER, PH.D. PC

Practice address

1421 Lee St
Brunswick, GA 31520-7132

Phone

(912) 265-0007

Fax

(912) 261-0593

NPI assigned

Jul 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Diana L Walther, PH.D.NPI 1235224882

Title

Psychologist/Owner

Phone

(912) 265-0007

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diana L. Walther, PH.D.

  • Clinical Psychologist
  • Brunswick, GA
  • NPI 1235224882
  NPD (past) Authorized official

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1568625747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 LEE ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315207132",
            "telephone_number": "912-265-0007",
            "fax_number": "912-261-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 LEE ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315207132",
            "telephone_number": "912-265-0007",
            "fax_number": "912-261-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANA L. WALTHER, PH.D. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "WALTHER",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "912-265-0007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY002320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10049299",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000829606D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.