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MR. JOE MICHAEL WALLER LPC
NPI 1790375103
Counselor - Professional in Mineola, TX

Active since January 20, 2021
703 W PATTEN ST, MINEOLA, TX 75773(903) 569-5409(900) 353-5738 Get Directions Write a Review

NPPES record last updated: August 15, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 15, 2022, Jan 5, 2022, Jan 21, 2021 (3 updates tracked since 2021).

About Mr. Joe Michael Waller Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JOE MICHAEL WALLER LPC (NPI 1790375103) is an individual professional provider in Mineola, Texas and active in the NPI registry since January 2021. He maintains a secondary practice location in Tyler.

NPPES Registry Identity

NPI1790375103
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. JOE MICHAEL WALLERCredential: LPC
Location Address703 W PATTEN STMineola, TX 75773-1541
Mailing Address2323 W Front StTyler, TX 75702-7704 · (903) 535-7421 · Fax (903) 535-7384
Phone(903) 569-5409
Fax(900) 353-5738
Sole ProprietorYes
Enumeration DateJanuary 20, 2021
Last NPPES UpdateAugust 15, 20223 updates tracked since enumeration
NPPES CertifiedAugust 15, 2022
✔ NPI 1790375103 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Also ListedCounselor · SchoolTaxonomy 101YS0200X
703 W PATTEN ST, Mineola, TX 75773
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Secondary Practice Location 1

Location 12323 W Front StTyler, TX 75702-7747 · Phone (903) 535-7421 · Fax (903) 535-7384

Other Identifiers 1

Medicaid419100901TX

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANNA CORINNE SHARP LCDC
Counselor (Addiction (Substance Use Disorder))
703 W PATTEN ST
MINEOLA, TX 75773
Wood County (903) 535-7366
MACK C LONG III
Counselor (Professional)
703 W PATTEN ST
MINEOLA, TX 75773
Wood County (903) 535-7344
NICOLE RHEA BENNETT PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
703 W PATTEN ST
MINEOLA, TX 75773
Wood County (903) 569-5409
DAN CLARKSON
Counselor (Mental Health)
703 W PATTEN ST
MINEOLA, TX 75773
Wood County (903) 569-5409
DAWN MARIE BUTTERFIELD
Counselor (Professional)
703 W PATTEN ST
MINEOLA, TX 75773
Wood County (903) 569-5409

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Joe Waller's NPI number?

The NPI number for Joe Waller is 1790375103. It was assigned to this individual provider in the NPPES registry on January 20, 2021.

Where is Joe Waller located?

Joe Waller practices at 703 W Patten St, Mineola, TX 75773. The listed phone number is (903) 569-5409.

What is Joe Waller's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Joe Waller was last updated on August 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.