Healthcare Provider Details

I. General information

NPI: 1689208985
Provider Name (Legal Business Name): KAREN ELIZABETH WALTERS LCSWA, LCAS-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 KEISLER DR STE 204
CARY NC
27518-9320
US

IV. Provider business mailing address

539 KEISLER DR STE 204
CARY NC
27518-9320
US

V. Phone/Fax

Practice location:
  • Phone: 808-271-3551
  • Fax:
Mailing address:
  • Phone: 808-271-3551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-26211
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC14948
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: