Healthcare Provider Details

I. General information

NPI: 1740943695
Provider Name (Legal Business Name): HARSHITA DESAI-WALTER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 GEORGE TOWNE DR
PEWAUKEE WI
53072-2731
US

IV. Provider business mailing address

200 DAIRY AVE
WAUKESHA WI
53188-2680
US

V. Phone/Fax

Practice location:
  • Phone: 414-266-3339
  • Fax: 262-691-4287
Mailing address:
  • Phone: 262-312-8509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8983125
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7983
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: