NPIMap

Organization Active NPI

Walters Walk

  • Professional Counselor
  • Hazelwood, MO
National Provider Identifier
1609442441
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
WALTERS WALK
Practice address
737 Dunn Rd
Hazelwood, MO 63042-1740
Phone
(314) 731-2433
Fax
(314) 731-4433
NPI assigned
Jun 2, 2021
Last updated
Jun 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Authorized official

Name
Dr. Jean Moretto, PHD, LPC, NCCNPI 1619959533
Title
Director
Phone
(314) 731-2433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Professional Counselor 101YP2500X NU Primary
Psychologist 103T00000X NU
Counseling Psychologist 103TC1900X NU
Social Worker 104100000X NU
Psychiatry Physician 2084P0800X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU

Addresses

Primary practice location

737 Dunn Rd
Hazelwood, MO 63042-1740

Mailing address

737 Dunn Rd
Hazelwood, MO 63042-1740
Phone (314) 731-2433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231212001689 MO Part B Supplier - Clinic/Group Practice 0547619819 Receives reassigned benefits from 8 practitioners
Practice locations: Hazelwood, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1609442441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 DUNN RD",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421740",
            "telephone_number": "314-731-2433",
            "fax_number": "314-731-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 DUNN RD",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421740",
            "telephone_number": "314-731-2433",
            "fax_number": "314-731-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTERS WALK",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "MORETTO",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-731-2433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazelwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.