Provider Demographics
NPI:1215350368
Name:WALTON, DIAMESHA DESHELL (LPC, CPCS)
Entity type:Individual
Prefix:MS
First Name:DIAMESHA
Middle Name:DESHELL
Last Name:WALTON
Suffix:
Gender:F
Credentials:LPC, CPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 KNOX PASS
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-2889
Mailing Address - Country:US
Mailing Address - Phone:678-673-7469
Mailing Address - Fax:678-807-1364
Practice Address - Street 1:27 KNOX PASS
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-2889
Practice Address - Country:US
Practice Address - Phone:678-673-7469
Practice Address - Fax:678-807-1364
Is Sole Proprietor?:No
Enumeration Date:2014-01-27
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
GALPC011011101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health