Healthcare Provider Details

I. General information

NPI: 1255269411
Provider Name (Legal Business Name): JOKILA ANN WALKER LCAS-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4804 PAGE CREEK LN
DURHAM NC
27703-8582
US

IV. Provider business mailing address

5306 NC HIGHWAY 55 STE 102
DURHAM NC
27713-7812
US

V. Phone/Fax

Practice location:
  • Phone: 919-672-2312
  • Fax:
Mailing address:
  • Phone: 919-672-2312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number31440
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: