MEDICARE: HALEY ELIZABETH 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	101YP2500X	Professional Counselor	2019006432	MO

General Provider Information

NPI Number	:	1962969667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY ELIZABETH WALKER LPC

Provider Business Mailing Address
First Line	:	25491 AUDRAIN ROAD 824
Second Line	:
City	:	MEXICO
State	:	MO
Zip	:	65265-6708
Country	:	US
Telephone Number	:	573-721-5506
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 E LOVE ST
Second Line	:
City	:	MEXICO
State	:	MO
Zip	:	65265-2880
Country	:	US
Telephone Number	:	573-721-5506
Fax Number	:	888-460-8878

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

Provider Enumeration Date	:	02/28/2019
Last Update Date	:	04/29/2025

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