Provider Demographics
NPI:1427629575
Name:KABWILA, WALINASE (MSW)
Entity type:Individual
Prefix:
First Name:WALINASE
Middle Name:
Last Name:KABWILA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:WALINASE
Other - Middle Name:
Other - Last Name:NYIRENDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12985 DELLINGER DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-9036
Mailing Address - Country:US
Mailing Address - Phone:317-960-8178
Mailing Address - Fax:
Practice Address - Street 1:12985 DELLINGER DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-9036
Practice Address - Country:US
Practice Address - Phone:317-960-8178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)