Individual
KEVIN WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCS, LCAS, CCS
Contact information
Practice address
363 GRAPHITE RD, OLD FORT, NC 28762-9455
(828) 668-7590
Mailing address
363 GRAPHITE RD, OLD FORT, NC 28762-9455
(828) 668-7590
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
20998
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3145
NC
101YM0800X
Mental Health Counselor
S7822
NC
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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