MEDICARE: MR. TROY ZAKARI WALKER CADC-I, PRSS-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist	PRSS-SUP-5097	NV
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	07795-I	NV

General Provider Information

NPI Number	:	1134353824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TROY ZAKARI WALKER CADC-I, PRSS-S

Provider Business Mailing Address
First Line	:	3350 N DURANGO DR APT 1115
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7295
Country	:	US
Telephone Number	:	504-881-7846
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 W VAN BUREN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3043
Country	:	US
Telephone Number	:	504-881-7846
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2009
Last Update Date	:	07/22/2024

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