Provider Demographics
NPI:1194897314
Name:WALTER, CHARITY LYNNE (NCC)
Entity type:Individual
Prefix:MRS
First Name:CHARITY
Middle Name:LYNNE
Last Name:WALTER
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 RANDALL AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-5636
Mailing Address - Country:US
Mailing Address - Phone:609-931-0309
Mailing Address - Fax:
Practice Address - Street 1:946 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-5304
Practice Address - Country:US
Practice Address - Phone:609-393-1626
Practice Address - Fax:609-393-3113
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor