PHYLLIS WALTERS PH.D. NPI 1679161491

NPI Information

NPI: 1679161491
Provider Name: PHYLLIS WALTERS, PH.D.
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
9220 BONITA BEACH RD SE STE 222
BONITA SPRINGS, FL
ZIP 34135
Phone: (239) 404-9396
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PHYLLIS WALTERS, PH.D. is a mental health (including community mental health center) clinic center in Bonita Springs, FL. PHYLLIS WALTERS, PH.D. NPI is 1679161491. The provider is registered as an organization entity type.

The provider's business location address is:

9220 BONITA BEACH RD SE STE 222
BONITA SPRINGS, FL
ZIP 34135-235
Phone: (239) 404-9396

The provider's authorized official is Marco Bianchi .
The authorized official title is Billing Manager and has the following contact phone number (239) 297-1508.

The enumeration date for this NPI number is 1/7/2021 and was last updated on 1/7/2021.

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	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health	No
2	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
3	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	Yes

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: 11/14/2023

NPI Synchronization or Removal

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