Walter William Lyman, CDCA
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Marietta, OH
NPI 1972306827 · NPPES record last updated Mar 28, 2025
Key facts
- NPI
- 1972306827
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CDCA.191905 (OH)
- Practice address
- 28407 State Route 7
Marietta, OH 45750-5152 - Phone
- (740) 371-5476
- NPI assigned
- Mar 28, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.191905 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.191905 | OH | Yes |
Addresses
Primary practice location
28407 State Route 7
Marietta, OH 45750-5152
Mailing address
28407 State Route 7
Marietta, OH 45750-5152
Phone (740) 371-5476
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CDCA.191905 | Medicaid | OH |
Other providers in Marietta, OH
- Peter E Lovejoy
- Ann Marie Lowers
- Sarah Beth Lowers
- Jennifer Lowman
- Leann Lynn Lucas
- Amanda Lynch
- Lynn Corpman Services, LLC
- Micayla Lyons
- Fortunato R Macatol
- Matthew J Macatol
All providers in Marietta, OH · Addiction (Substance Use Disorder) Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.