Phyllis Walters, PH.D.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PHYLLIS WALTERS, PH.D.

Practice address

9220 Bonita Beach Rd SE Ste 222
Bonita Springs, FL 34135-4235

Phone

(239) 404-9396

NPI assigned

Jan 7, 2021

Organization subpart

No

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

Authorized official

Name

Marco Bianchi

Title

Billing Manager

Phone

(239) 297-1508

Specialties & licenses 3

Addresses

Other names 1

• Phyllis Walters, Ph.D. Doing business as

Locations

Practitioners 1

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

• Phyllis Annette Walters

  • School Psychologist
  • Bonita Springs, FL
  • NPI 1326684044
  NPD

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1679161491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9248 CYPRESS DR N",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339675440",
            "telephone_number": "239-297-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9220 BONITA BEACH RD SE STE 222",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354235",
            "telephone_number": "239-404-9396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYLLIS WALTERS, PH.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "BIANCHI",
        "authorized_official_first_name": "MARCO",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "239-297-1508"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phyllis Walters, Ph.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gregory Asher Pette, D.M.D., M.S.
• William A. Pettinger, M.D.
• Jacqueline Pettit, DPT
• Todd A Pezzi, MD
• PHC Management Services, LLC
• Physiotherapy Associates Inc.
• Sophia Pierre Pierre Philippe
• Pilot Healthcare P.L.
• Pilot Healthcare P.L.
• Robert Richard Pinello, PAC MPAS

• Mental Health Clinic/Center (Including Community Mental Health Center) in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.