Healthcare Provider Details

I. General information

NPI: 1932843521
Provider Name (Legal Business Name): NIKKI WALKER LCSW-A, LCAS-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 NW MAYNARD RD
CARY NC
27513-3401
US

IV. Provider business mailing address

PO BOX 126
KNIGHTDALE NC
27545-0126
US

V. Phone/Fax

Practice location:
  • Phone: 919-858-2375
  • Fax:
Mailing address:
  • Phone: 919-858-2375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP017189
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: