Individual provider · Type 1 NPI

Walter Pedersen, CADC II

Addiction (Substance Use Disorder) Counselor · South Lake Tahoe, CA

NPI number 1730301128 Active

Practice location

2494 Lake Tahoe Blvd Ste B2
South Lake Tahoe, CA 96150-7142

Call (530) 541-4594 Map

Mailing address

3668 Spruce Ave, Apt. 19
South Lake Tahoe, CA 96150-7497

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1730301128

Walter Pedersen, CADC II's National Provider Identifier is 1730301128, issued on May 3, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in South Lake Tahoe, CA. The record was last updated on Apr 10, 2014.