Individual provider · Type 1 NPI
Kevin Waller, LPCS, LCAS, CCS
Addiction (Substance Use Disorder) Counselor · Old Fort, NC
NPI number
1023596244
Active
Practice location
363 Graphite Rd
Old Fort, NC 28762-9455
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 20998 (NC) |
| Mental Health Counselor | 101YM0800X | S7822 (NC) |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 3145 (NC) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
4 other providers at this address
- Suws of the CarolinasEmotionally Disturbed Childrens' Residential Treatment Facility Old Fort, NC NPI 1740470798
- Suws of the CarolinasEmotionally Disturbed Childrens' Residential Treatment Facility Old Fort, NC NPI 1992025860
- Jennifer Ann Stulck, LCMHCMental Health Counselor Old Fort, NC NPI 1245969997
- Katherine Alice Cennamo, LCSWClinical Social Worker Old Fort, NC NPI 1588142707
About NPI 1023596244
Kevin Waller, LPCS, LCAS, CCS's National Provider Identifier is 1023596244, issued on Jul 31, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Old Fort, NC. The record was last updated on Jul 31, 2018.