William Dakota Walters

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

174172 Issued in KY

Practice address

1203 American Greeting Card Rd
Corbin, KY 40701-4811

Phone

(606) 526-9552

NPI assigned

Apr 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cumberland River Behavioral Health, Inc

  • Community/Behavioral Health Agency
  • Corbin, KY
  • NPI 1902023526
  NPD (past)

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1699263418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 MASTER ST APT B103",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407011096",
            "telephone_number": "606-627-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 AMERICAN GREETING CARD RD",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407014811",
            "telephone_number": "606-526-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "WILLIAM",
        "middle_name": "DAKOTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-26",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "174172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyce Lynn Waller, BS
• Dillon Kyle Walls, BS
• Andrea Walters, DMD
• James William Walters Jr., BS
• Skyla Dawn Walters
• Bailee Alyce Wang, DO
• Boyang Wang, DO
• James Ronnie Ward II, R.N
• Michael Warren, BS,MA,ID
• Amanda G Watkins, FNP-C

• Addiction (Substance Use Disorder) Counselor in Corbin, KY
• Providers in Corbin, KY by specialty
• Addiction (Substance Use Disorder) Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; 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.