Individual
MICHAEL WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS
Contact information
Practice address
309 PROGRESS DR, BURGAW, NC 28425-3280
(102) 590-6689
(910) 202-9966
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 202-5709
(910) 202-9966
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20516
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191237881
—
NC
Enumeration date
10/18/2015
Last updated
04/28/2022
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