Provider Demographics
NPI:1538391735
Name:WALTERS, CHRISTY LYN (MHC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:LYN
Last Name:WALTERS
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:MISS
Other - First Name:CHRISTY
Other - Middle Name:LYN
Other - Last Name:EVERSOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6652 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-2618
Mailing Address - Country:US
Mailing Address - Phone:317-489-8178
Mailing Address - Fax:
Practice Address - Street 1:1635 W MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-3852
Practice Address - Country:US
Practice Address - Phone:317-524-4627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health