MEDICARE: AUTUMN FRANCHESCA WALTERS

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	101YM0800X	Mental Health Counselor	A22383	NC

General Provider Information

NPI Number	:	1447992060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUTUMN FRANCHESCA WALTERS

Provider Business Mailing Address
First Line	:	5700 EXECUTIVE CENTER DR STE 110
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-8833
Country	:	US
Telephone Number	:	866-272-7826
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 EXECUTIVE CENTER DR STE 110
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-8833
Country	:	US
Telephone Number	:	866-272-7826
Fax Number	:

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

Provider Enumeration Date	:	04/13/2022
Last Update Date	:	01/21/2026

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