Jennifer Walters, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC004264 Issued in PA

Practice address

1740 South St Ste 403
Philadelphia, PA 19146-1514

Phone

(215) 990-4390

NPI assigned

Oct 23, 2006

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

Opted out of Medicare

Yes, effective Mar 6, 2024 through Mar 6, 2028

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.

• Walters Counseling, LLC

  • Professional Counselor
  • Philadelphia, PA
  • NPI 1093118721
  NPD (past) Authorized official

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1760565022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190950074",
            "telephone_number": "215-990-4390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 SOUTH ST STE 403",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461514",
            "telephone_number": "215-990-4390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1904 South St",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191461434",
            "country_code": "US",
            "telephone_number": "215-990-4390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JENNIFER",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC004264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle D Walter, PA
• Nicole Walter
• Sarah Walter, CCC-SLP
• Walters Counseling, LLC
• Evelyn Walters
• Julie Anne Walters, HEALTH COACH
• M. Ingre Walters, MD
• Matthew James Walters, DDS
• Rameen Kristopher Walters, MD
• Randolph Walters, PSY.D

• Professional Counselor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.