Provider Demographics
NPI:1447453287
Name:SADLER, WALTER LEE JR (LPC)
Entity type:Individual
Prefix:MR
First Name:WALTER
Middle Name:LEE
Last Name:SADLER
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:WALTER
Other - Middle Name:LEE
Other - Last Name:SADLER
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 1216
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-1216
Mailing Address - Country:US
Mailing Address - Phone:252-792-8035
Mailing Address - Fax:252-792-8045
Practice Address - Street 1:607 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2645
Practice Address - Country:US
Practice Address - Phone:252-792-8035
Practice Address - Fax:252-792-8045
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6628101YP2500X, 101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1447453287Medicaid