MEDICARE: KELSEY WALKER

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	101YM0800X	Mental Health Counselor	LH61518587	WA

General Provider Information

NPI Number	:	1861259129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY WALKER

Provider Business Mailing Address
First Line	:	160 W 71ST ST PH E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-3944
Country	:	US
Telephone Number	:	214-770-2519
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 W 71ST ST PH E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-3944
Country	:	US
Telephone Number	:	214-770-2519
Fax Number	:

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

Provider Enumeration Date	:	03/04/2024
Last Update Date	:	03/04/2024

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Directions to “ KELSEY WALKER ” Practice Location

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