Healthcare Provider Details

I. General information

NPI: 1003634254
Provider Name (Legal Business Name): EVENY WALKER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EVENY GRIFFIN LMFT

II. Dates (important events)

Enumeration Date: 09/27/2024
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 CANTERBURY DR STE C
VALDOSTA GA
31602-0503
US

IV. Provider business mailing address

1801 CANTERBURY DR STE C
VALDOSTA GA
31602-0503
US

V. Phone/Fax

Practice location:
  • Phone: 229-244-2030
  • Fax:
Mailing address:
  • Phone: 229-244-2030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT002072
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: