TINA M WALTERS – Professional Counselor, NPI 1023605219

TINA M WALTERS is a healthcare provider. based in Geneva, Illinois. specializing in MENTAL HEALTH COUNSELOR. The NPI Number for TINA M WALTERS is 1023605219

Main info

Female
38 Years Of Experience
Name
TINA M WALTERS
NPI
1023605219
Phone
(224) 699-0603
Address
825 W STATE ST STE 103F
Enumeration Date
22 December 2020
Last Update Date
20 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8666300966
Graduation Year
1988 (38 years ago)
PAC ID
5991294340
Group Practice PAC ID
0547795791
Professional Enrollment ID
I20251028000371
Address ID
IL616023126PE416XXSTXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:5State licenses:0Digital endpointsOther names

2,307 MENTAL HEALTH COUNSELOR in IL

Provider Addresses for TINA M WALTERS

  • 825 W STATE ST STE 103F

    GENEVA, IL 601342080

    Phone: (224) 699-0603

    Type: Location

  • PO BOX 563

    MEDINAH, IL 601570563

    Phone:

    Type: Mailing

  • 7N271 BRIARGATE TER

    MEDINAH, IL 601579510

    Phone: (630) 453-9322

    Type: Location

  • 1713 RIVERSIDE AVE

    ST CHARLES, IL 601744369

    Phone: (630) 453-9322

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251027004640IMental Health CounselorFLTBD
I20251028000371IMental Health CounselorILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60134)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547795791View full group profile
NameSpecialtyState
Mental Health CounselorSC
Mental Health CounselorIL
Clinical Social WorkerCT
Clinical Social WorkerIL
Nurse PractitionerNC
Clinical Social WorkerIL
Mental Health CounselorNC
Mental Health CounselorCO
Clinical Social WorkerCO
Mental Health CounselorSC

Reviews

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Frequently asked questions

What is TINA M WALTERS's NPI number?
TINA M WALTERS's NPI is 1023605219 — the number used across U.S. healthcare to identify this provider.
Is TINA M WALTERS shown as active in public data?
Registry records indicate TINA M WALTERS maintains an active NPI.
What kind of doctor is TINA M WALTERS?
TINA M WALTERS is associated with Professional Counselor in the directory — Clinical services aligned with this taxonomy classification.
Is TINA M WALTERS associated with Geneva?
Public fields place TINA M WALTERS around Geneva, Illinois. Always confirm the exact site before visiting.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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TRICITY FAMILY SERVICES

Mental Health Clinic/Center (Including Community Mental Health Center)
1120, Randall Court, Geneva, Kane County, Illinois, 60134, United States
NPI: 1598850778