Healthcare Provider Details

I. General information

NPI: 1326781451
Provider Name (Legal Business Name): FAITH WALKER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2022
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 COREY ST STE 2
WEST ROXBURY MA
02132-1932
US

IV. Provider business mailing address

77 CUSHING RD
MILTON MA
02186-1234
US

V. Phone/Fax

Practice location:
  • Phone: 914-924-9798
  • Fax:
Mailing address:
  • Phone: 914-924-9798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10002694
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: