Lisa Marie Walters | Valparaiso, IN • PECOS Search

Lisa Marie Walters

Counselor

Behavioral Health & Social Service Providers

2006 Valparaiso St, Valparaiso, IN 46383-3138

PECOS Enrollment

Based on the most recent information from CMS, provider Lisa Marie Walters does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 11:05 AM.

Profile Details

Provider ID
1790274819
Provider Type
Individual
Full Name
Walters, Lisa Marie
Title
Mrs.
Credential
LMHC-A, NCC

Gender
Female
Sole Proprietor
No
Enumeration Date
5/3/2018
Last Updated
5/3/2018

Contact Information

Practice Location

2006 Valparaiso St, Valparaiso, IN 46383-3138

Unlisted Fax

Mailing Location

508 Wildflower Way, Wanatah, IN 46390-9403

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License 88000522A Indiana