=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477040426
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAURA ELIZABETH WALTON LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/16/2018
-----------------------------------------------------
Last Update Date | 06/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9327 E VENUS DR
-----------------------------------------------------
City | CAREFREE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85377-4196
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-433-3032
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2930 N 8TH AVE
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85013-4002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-433-3032
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | LMFT15249
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------