| Walters Walk | |
|
737 Dunn Rd Hazelwood MO 63042-1740 | |
| (314) 731-2433 | |
| (314) 731-4433 |
| Full Name | Walters Walk |
|---|---|
| Speciality | Counselor |
| Location | 737 Dunn Rd, Hazelwood, Missouri |
| Authorized Official Name and Position | Jean Moretto (DIRECTOR) |
| Authorized Official Contact | 3147312433 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Walters Walk 737 Dunn Rd Hazelwood MO 63042-1740 Ph: (314) 731-2433 | Walters Walk 737 Dunn Rd Hazelwood MO 63042-1740 Ph: (314) 731-2433 |
| NPI Number | 1609442441 |
|---|---|
| Provider Enumeration Date | 06/02/2021 |
| Last Update Date | 06/02/2021 |
| Certification Date | 06/01/2021 |
| Medicare PECOS PAC ID | 0547619819 |
|---|---|
| Medicare Enrollment ID | O20231212001689 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609442441 | NPI | - | NPPES |
| Provider Name | Jean Earlene Moretto |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619959533 PECOS PAC ID: 5092164368 Enrollment ID: I20231212001971 |
| Provider Name | Michael David Richardson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154510196 PECOS PAC ID: 2961852645 Enrollment ID: I20231220003601 |
| Provider Name | William Collins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134689466 PECOS PAC ID: 9133571979 Enrollment ID: I20240117003906 |
| Provider Name | Stephen Wayne Stewart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184378853 PECOS PAC ID: 3870003619 Enrollment ID: I20250610003046 |
| Provider Name | Tresa Renee Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023305166 PECOS PAC ID: 7810474863 Enrollment ID: I20260121001530 |
| Provider Name | Lori Joyce Bosma |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427830900 PECOS PAC ID: 1355829920 Enrollment ID: I20260204001110 |
| Provider Name | Israelneisha Renee Eleby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609631910 PECOS PAC ID: 2567941586 Enrollment ID: I20260210002406 |
| Provider Name | Robert Woods Phillips |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144092362 PECOS PAC ID: 5496224974 Enrollment ID: I20260513004053 |
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