NPIMap

Organization Active NPI

Walton Brueske Counseling Group PA

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1801002431
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH2109 Issued in FL
Legal business name
WALTON BRUESKE COUNSELING GROUP PA
Practice address
3810-1 Williamsburg Park Blvd
Jacksonville, FL 32257-9217
Phone
(904) 733-9669
Fax
(904) 733-4194
NPI assigned
May 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert Scott Walton, PHDNPI 1336127711
Title
President
Phone
(904) 733-9669

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X MH2109 FL Primary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X MH209 FL

Addresses

Primary practice location

3810-1 Williamsburg Park Blvd
Jacksonville, FL 32257-9217

Mailing address

3810-1 Williamsburg Park Blvd
Jacksonville, FL 32257-9217
Phone (904) 733-9669

National Provider Directory

National Provider Directory

Locations

3810-1 Williamsburg Park Blvd
Jacksonville, FL 32257
Phone (904) 733-9669

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801002431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810-1 WILLIAMSBURG PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322579217",
            "telephone_number": "904-733-9669",
            "fax_number": "904-733-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810-1 WILLIAMSBURG PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322579217",
            "telephone_number": "904-733-9669",
            "fax_number": "904-733-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTON BRUESKE COUNSELING GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-733-9669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH2109",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.