Provider Demographics
NPI:1801346671
Name:WALTERS, MICHAEL J (LCPC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:WALTERS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:435 CLAREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-2105
Mailing Address - Country:US
Mailing Address - Phone:630-405-8546
Mailing Address - Fax:630-982-3138
Practice Address - Street 1:201 E ARMY TRAIL RD STE 207
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2103
Practice Address - Country:US
Practice Address - Phone:630-358-9040
Practice Address - Fax:630-982-3138
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health