Healthcare Provider Details

I. General information

NPI: 1447194261
Provider Name (Legal Business Name): ANGELA WALKER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11166 TESSON FERRY RD STE 308
SAINT LOUIS MO
63123-6966
US

IV. Provider business mailing address

3858 MARCIA DR
SAINT CHARLES MO
63304-7054
US

V. Phone/Fax

Practice location:
  • Phone: 314-568-4390
  • Fax:
Mailing address:
  • Phone: 314-568-4390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2026012659
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: