DR. BYRON WALLER PH.D. NPI 1013064328

NPI Information

NPI: 1013064328
Provider Name: DR. BYRON WALLER, PH.D.
Classification: Counselor - 101Y00000X
Entity Type: Individual
Address:
401 E 162ND ST
SUITE 109
SOUTH HOLLAND, IL
ZIP 60473
Phone: (708) 339-2769
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DR. Byron Waller, PH.D. is a counselor in South Holland, IL. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. DR. Byron Waller, PH.D. NPI is 1013064328. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

401 E 162ND ST
SUITE 109
SOUTH HOLLAND, IL
ZIP 60473-236
Phone: (708) 339-2769

The enumeration date for this NPI number is 1/5/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	101Y00000X	Counselor		ILLINOIS	Yes
2	101YM0800X	Counselor	Mental Health	ILLINOIS	X
3	101YP2500X	Counselor	Professional	ILLINOIS	X

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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