Clova Walters, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD040380-L Issued in PA

Practice address

865 E 4TH St
Bethlehem, PA 18015-1935

Phone

(610) 691-4357

Fax

(484) 221-9130

NPI assigned

Feb 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Hispanic American Organization

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Allentown, PA
  • NPI 1629183264
  NPD (past)
• New Directions Treatment Services

  • Community/Behavioral Health Agency
  • Bethlehem, PA
  • NPI 1790829505
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1891836573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4240",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181054240",
            "telephone_number": "484-432-6848",
            "fax_number": "888-416-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 E 4TH ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151935",
            "telephone_number": "610-691-4357",
            "fax_number": "484-221-9130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "307 E 4th St",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180151775",
            "country_code": "US",
            "telephone_number": "610-849-2291",
            "fax_number": "888-416-1801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "CLOVA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD040380-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH 65 COMPLETE",
            "identifier": "E45224",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001175208",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALT",
            "identifier": "E45224",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY 65 COMPLETE",
            "identifier": "596189",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erik Jack Wallace, PA-C
• Brian T Walsh, CRNA
• Jonathan Williams Walsh, MD
• Kelsey Walter
• Kevin Walter, M.A.
• Jaimee Walters, LSW
• Joelle Walters
• Tracy Walters, LPC
• Elizabeth J. Walton-Phillips, LCSW
• Kellie Wanamaker

• Psychiatry Physician in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.