Allison Waltz, LPC

Individual provider Active NPI Professional Counselor · Brooks, GA

NPI 1942953229 · NPPES record last updated Nov 3, 2024

Key facts

NPI
1942953229
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
1961671 (ID)
Practice address
465 Tri County Rd
Brooks, GA 30205-2451
Phone
(404) 354-1286
NPI assigned
Jan 27, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1961671IDMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1961671 ID Yes
Doula 374J00000X

Addresses

Primary practice location

465 Tri County Rd
Brooks, GA 30205-2451

Mailing address

465 Tri County Rd
Brooks, GA 30205-2451
Phone (404) 354-1286

Other providers in Brooks, GA

All providers in Brooks, GA · Professional Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.