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General NPI Number Information
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NPI Number | 1023194461
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Entity Type | Individual
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Provider Name | KAREN L. WALLER MS LPC LMHP
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Gender | Female
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Dates
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Enumeration Date | 10/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5205 2ND AVE
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City | KEARNEY
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State | NE
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Zip | 68847-2471
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Country | US
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Telephone | 308-237-5596
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 955
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City | KEARNEY
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State | NE
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Zip | 68848-0955
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Country | US
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Telephone | 308-237-5596
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 213
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 262
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License Number State | NE
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