MEDICARE: MR. DANIEL JOSEPH WALTERS MA, LAPC

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	APC005289	GA

General Provider Information

NPI Number	:	1588116644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL JOSEPH WALTERS MA, LAPC

Provider Business Mailing Address
First Line	:	8046 ROSWELL RD
Second Line	:	SUITE 101 C
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30350-7023
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8046 ROSWELL RD
Second Line	:	SUITE 101 C
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30350-7023
Country	:	US
Telephone Number	:	404-580-7150
Fax Number	:

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

Provider Enumeration Date	:	10/25/2016
Last Update Date	:	10/25/2016

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