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NPI Code Detail

MEDICARE: JORDAN WALKER LPC

MEDICARE: JORDAN 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
1101YM0800XMental Health Counselor95801TX

General Provider Information

NPI Number : 1942130604
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN WALKER LPC
Provider Business Mailing Address
First Line : 7122 STONEWALL HL
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78256-1926
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7122 STONEWALL HL
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78256-1926
Country : US
Telephone Number : 210-404-9696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2026
Last Update Date : 05/22/2026

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