Katie Waller, LCDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

12081 Issued in TX

Practice address

1523 Normal Park Dr
Suite C
Huntsville, TX 77340-4297

Phone

(855) 862-3278

NPI assigned

Apr 26, 2017

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1750816930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 474",
            "city": "ANGLETON",
            "state": "TX",
            "postal_code": "775160474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 NORMAL PARK DR",
            "address_2": "SUITE C",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404297",
            "telephone_number": "855-862-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "KATIE",
        "credential": "LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-26",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walker County Hospital Corporation
• Fred Eugene Walker II, PHARMD
• Martel Walker
• Tiffany Walla, MS, RD, LD
• Benjamin Levi Wallace, FNP-C
• Sonja Lynne Walls
• John Q Wang, PAC
• Jesse Scott Ward, M.D.
• Dyvette L Warren, PAC
• Lilian Judy Wangari Warren, NEMT

• Addiction (Substance Use Disorder) Counselor in Huntsville, TX
• Providers in Huntsville, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; 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.