Jon Waller, LMHC

Counselor · Tamarac, FL

Individual Active NPI

NPI number 1790331270

Practice location

4800 W Commercial Blvd
Tamarac, FL 33319-2879
Phone
(954) 300-3244

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NPI record

NPI
1790331270
Entity type
Individual (Type 1)
Enumeration date
August 12, 2019
Last updated
August 12, 2019
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Counselor Primary 101Y00000X MH12508 FL

Mailing address

925 Intracoastal Dr Apt 8
Fort Lauderdale, FL 33304-3688
Phone
(352) 246-4027

About Jon Waller

Jon Waller, LMHC is a healthcare provider registered in the NPI registry with the primary taxonomy Counselor (code 101Y00000X). The practice location is 4800 W Commercial Blvd, Tamarac, FL 33319-2879. The NPI number 1790331270 was assigned on August 12, 2019 and the record was last updated on August 12, 2019.

Jon Waller lists a license in the registry: #MH12508 (FL) for Counselor. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jon Waller, LMHC?

The NPI number is 1790331270.

What is the phone number of Jon Waller?

The phone number listed for the practice location is (954) 300-3244.

Where is Jon Waller located?

4800 W Commercial Blvd, Tamarac, FL 33319-2879.

What is the taxonomy code for Jon Waller?

The primary taxonomy code is 101Y00000X – Counselor.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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