MEDICARE: WALTER MAJOR LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	200172571	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376639815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WALTER MAJOR LPC

Provider Business Mailing Address
First Line	:	1286 MATTHEWS LN
Second Line	:
City	:	PARK HILLS
State	:	MO
Zip	:	63601-7207
Country	:	US
Telephone Number	:	573-562-7751
Fax Number	:	573-562-7843

Provider Business Practice Location Address
First Line	:	1286 MATTHEWS LN
Second Line	:
City	:	PARK HILLS
State	:	MO
Zip	:	63601-7207
Country	:	US
Telephone Number	:	573-562-7751
Fax Number	:	573-562-7843

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	12/02/2016

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