Active NPI
Larry L Walls, LICENSED PROFESSIONA
- Professional Counselor
- Mauston, WI
National Provider Identifier
1720403082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6769-125
- Practice address
- Juneau County Dept of Human Services
200 Hickory St
Mauston, WI 53948 - Phone
- (608) 847-2400
- Fax
- (608) 847-9421
- NPI assigned
- Feb 24, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6769-125 | WI | Primary |
Addresses
Primary practice location
Juneau County Dept of Human Services
200 Hickory St
Mauston, WI 53948
Mailing address
Juneau County Dept of Human Services
200 Hickory St
Mauston, WI 53948
Phone (608) 847-2400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6769-125 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530230400000",
"number": "1720403082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "JUNEAU COUNTY DEPT OF HUMAN SERVICES",
"address_2": "200 HICKORY ST",
"city": "MAUSTON",
"state": "WI",
"postal_code": "53948",
"telephone_number": "608-847-2400",
"fax_number": "608-847-9421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "JUNEAU COUNTY DEPT OF HUMAN SERVICES",
"address_2": "200 HICKORY ST",
"city": "MAUSTON",
"state": "WI",
"postal_code": "53948",
"telephone_number": "608-847-2400",
"fax_number": "608-847-9421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLS",
"first_name": "LARRY",
"middle_name": "L",
"credential": "LICENSED PROFESSIONA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-24",
"last_updated": "2018-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "6769-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mauston, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.