Healthcare Provider Details

I. General information

NPI: 1386087641
Provider Name (Legal Business Name): LISA C. WALKER LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2013
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14104 WARWICK BLVD # 2111
NEWPORT NEWS VA
23602-5653
US

IV. Provider business mailing address

14104 WARWICK BLVD # 2111
NEWPORT NEWS VA
23602-5653
US

V. Phone/Fax

Practice location:
  • Phone: 443-216-9531
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701014967
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC11218
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: