Jesse Patrick Waltz, MAED, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166.001334 Issued in IL

Practice address

8658 S Sacramento Ave
Chicago, IL 60652-3800

Phone

(773) 962-3740

NPI assigned

May 14, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Seeds of Hope Family Therapy, PLLC

  • Marriage & Family Therapist
  • Elizabethtown, KY
  • NPI 1184915019
  Authorized official Same address or phone

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1619313988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 204",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605440204",
            "telephone_number": "270-312-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8658 S SACRAMENTO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606523800",
            "telephone_number": "773-962-3740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25310 W Maggie Ln",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "IL",
            "postal_code": "605866831",
            "country_code": "US",
            "telephone_number": "270-312-7752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTZ",
        "first_name": "JESSE",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "MAED, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-14",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "104021",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.001334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latricia Walton, RMA
• Robert Lee Walton, M.D.
• Ruth Ann Walton, NP
• Samantha Michelle Walton, RDN
• William Joseph Walton
• Ellen R Walukas, DNP
• Marianne Eve Walwema
• Elizabeth Walz-Buscher, M.D
• Amy Leanne Walz, M.D.
• Kristina M Walz, LPC

• Marriage & Family Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.