Healthcare Provider Details

I. General information

NPI: 1780616607
Provider Name (Legal Business Name): KAREN RENAY WALKER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 02/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W I 240 SERVICE RD
OKLAHOMA CITY OK
73139-7701
US

IV. Provider business mailing address

301 W I 240 SERVICE RD
OKLAHOMA CITY OK
73139-7701
US

V. Phone/Fax

Practice location:
  • Phone: 405-604-9644
  • Fax: 405-604-9689
Mailing address:
  • Phone: 405-604-9644
  • Fax: 405-604-9689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1909
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number228
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number659
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: