Provider Demographics
NPI:1275353195
Name:WALTON, MARCUS W (LCMHCA)
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:W
Last Name:WALTON
Suffix:
Gender:M
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 NORTH DUKE ST
Mailing Address - Street 2:STE 1 #1076
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704
Mailing Address - Country:US
Mailing Address - Phone:919-885-4079
Mailing Address - Fax:
Practice Address - Street 1:307 W GEER ST APT A
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-2237
Practice Address - Country:US
Practice Address - Phone:919-885-4079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health