Provider Demographics
NPI:1487186110
Name:DARBY WALTON
Entity type:Organization
Organization Name:DARBY WALTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DARBY
Authorized Official - Middle Name:D
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, CADC-I
Authorized Official - Phone:662-710-8570
Mailing Address - Street 1:6573 WHITE HAWK LN
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-6387
Mailing Address - Country:US
Mailing Address - Phone:662-710-8570
Mailing Address - Fax:
Practice Address - Street 1:6858 SWINNEA RD
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-9493
Practice Address - Country:US
Practice Address - Phone:662-536-6210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2122101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty