Active NPI
Caryn M. Walters, MS, LPCC
- Professional Counselor
- Virginia, MN
National Provider Identifier
1972874105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CC00402
- Practice address
- 504 1St St. S.
Virginia, MN 55792 - Phone
- (218) 741-4714
- Fax
- (218) 741-3080
- NPI assigned
- Jan 19, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC00402 | MN | |
| Professional Counselor | 101YP2500X | CC00402 | MN | Primary |
Addresses
Primary practice location
504 1St St. S.
Virginia, MN 55792
Mailing address
PO Box 1188
629 S. 13TH St.
Virginia, MN 55792
Phone (218) 741-4714
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC00402 | MN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418083200000",
"number": "1972874105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1188",
"address_2": "629 S. 13TH ST.",
"city": "VIRGINIA",
"state": "MN",
"postal_code": "55792",
"telephone_number": "218-741-4714",
"fax_number": "218-741-3080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 1ST ST. S.",
"city": "VIRGINIA",
"state": "MN",
"postal_code": "55792",
"telephone_number": "218-741-4714",
"fax_number": "218-741-3080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "CARYN",
"middle_name": "M.",
"credential": "MS, LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-19",
"last_updated": "2014-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "CC00402",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "CC00402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.