MEDICARE: JENNIFER R WALKER LPC

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	101Y00000X	Counselor	PC004402	PA
2	101YP2500X	Professional Counselor	PC004402	PA
3	101YM0800X	Mental Health Counselor	PC004402	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720109069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER R WALKER LPC

Provider Business Mailing Address
First Line	:	902 MARKET ST
Second Line	:
City	:	MEADVILLE
State	:	PA
Zip	:	16335-3319
Country	:	US
Telephone Number	:	814-219-3800
Fax Number	:	814-219-3805

Provider Business Practice Location Address
First Line	:	902 MARKET ST
Second Line	:
City	:	MEADVILLE
State	:	PA
Zip	:	16335-3319
Country	:	US
Telephone Number	:	814-219-3800
Fax Number	:	814-219-3805

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

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	11/01/2024

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