Provider Demographics
NPI:1861102238
Name:WALTON-KELLY, LAUREN ASHLEY (BA , CDC I)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ASHLEY
Last Name:WALTON-KELLY
Suffix:
Gender:F
Credentials:BA , CDC I
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ASHLEY
Other - Last Name:WALTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDCI
Mailing Address - Street 1:6000 KANAKANAK RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:DILLINGHAM
Mailing Address - State:AK
Mailing Address - Zip Code:99576
Mailing Address - Country:US
Mailing Address - Phone:907-842-5201
Mailing Address - Fax:
Practice Address - Street 1:6000 KANAKANAK RD
Practice Address - Street 2:SUITE 130
Practice Address - City:DILLINGHAM
Practice Address - State:AK
Practice Address - Zip Code:99576-9957
Practice Address - Country:US
Practice Address - Phone:907-842-5201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)