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General NPI Number Information
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NPI Number | 1629407911
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Entity Type | Individual
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Provider Name | MADDIE ANN WALTMAN LPCC, LPC
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Gender | Female
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Dates
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Enumeration Date | 11/06/2013
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 71 CAVALIER BLVD STE 313
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City | FLORENCE
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State | KY
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Zip | 41042-5172
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Country | US
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Telephone | 859-302-9877
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Fax |
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Provider Business Mailing Address
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Address Line | 71 CAVALIER BLVD STE 313
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City | FLORENCE
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State | KY
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Zip | 41042-5172
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Country | US
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Telephone | 859-302-9877
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.130897
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 274636
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ADC.00000128
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCDCIII.161165
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.2304729-TRNE
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.2406163
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License Number State | OH
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Taxonomy #7
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 292469
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License Number State | KY
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