NPIMap

Organization Active NPI

Tommie L. Walton, III Inc.

Doing business as Recovery Cafe/ Larry Walton and Assoc.

  • Psychologist
  • Athens, GA
National Provider Identifier
1760538581
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
000692 Issued in GA
Legal business name
TOMMIE L. WALTON, III INC.
Doing business as
Recovery Cafe/ Larry Walton and Assoc.
Practice address
325 N Milledge Ave
Athens, GA 30601-3805
Phone
(706) 369-0970
Fax
(706) 353-1943
NPI assigned
Jan 26, 2007
Last updated
Jun 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Mr. Tommie L. Walton III, LCSWNPI 1356329452
Title
President/Owner
Phone
(706) 369-0970

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 000692 GA Primary

Addresses

Primary practice location

325 N Milledge Ave
Athens, GA 30601-3805

Mailing address

PO Box 7392
Athens, GA 30604-7392
Phone (706) 369-0970

Other identifiers 1

IdentifierTypeStateIssuer
004509000OtherGAMAGELLAN ID#

Other names 1

  • Recovery Cafe/ Larry Walton and Assoc. Doing business as

National Provider Directory

National Provider Directory

Locations

325 N Milledge Ave
Athens, GA 30601
Phone (706) 202-6952

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1760538581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7392",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306047392",
            "telephone_number": "706-369-0970",
            "fax_number": "706-353-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N MILLEDGE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306013805",
            "telephone_number": "706-369-0970",
            "fax_number": "706-353-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMMIE L. WALTON, III INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "TOMMIE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "706-369-0970",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "000692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN ID#",
            "identifier": "004509000",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Recovery Cafe/ Larry Walton and Assoc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.