Basic Information
| Provider Information | |||||||||
| NPI: | 1447645346 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAUNDERS | ||||||||
| FirstName: | WALTER | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LMSW CSW-INTERN LADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9755 SILVER SKY PKWY APT 4201 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895062227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753429473 | ||||||||
| FaxNumber: | 7753221544 | ||||||||
| Practice Location | |||||||||
| Address1: | 205 S PRATT AVE | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897014730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758823945 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2015 | ||||||||
| LastUpdateDate: | 08/18/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 06635-L | NV | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YA0400X | 06632-LCI | NV | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 104100000X | 8967-S | NV | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | IC-1640 | NV | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | IC-1640 | 01 | NV | STATE OF NEVADA BOARD OF EXAMINERS FOR SOCIAL WORKERS | OTHER | 8967-S | 01 | NV | STATE OF NEVADA BOARD OF EXAMINERS FOR SOCIAL WORKERS | OTHER | 06632-LCI | 01 | NV | NEVADA STATE BOARD OF EXAMINERS FOR ALCOHOL, DRUG AND GAMBLING | OTHER | 06635-L | 01 | NV | NEVADA STATE BOARD OF EXAMINERS FOR ALCOHOL, DRUG AND GAMBLING COUNSELORS | OTHER |