Kevin Waller, LPCS, LCAS, CCS

NPI #1023596244 in Old Fort, North Carolina

Provider Information

NPI Number: 1023596244
Entity Type: Individual
Name: Kevin Waller, LPCS, LCAS, CCS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Credential: LPCS, LCAS, CCS
Enumeration Date: Jul 31, 2018
Last Updated: Jul 31, 2018

Practice Location

Address: 363 GRAPHITE RD
City: Old Fort
State: North Carolina
ZIP Code: 28762-9455
Phone: (828) 668-7590

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary
Counselor - Mental Health — Mental Health	101YM0800X

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