Healthcare Provider Details

I. General information

NPI: 1558939447
Provider Name (Legal Business Name): DESTINEY CHARDONAY WALKER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 HUGUENOT RD STE 201
NORTH CHESTERFIELD VA
23235-4314
US

IV. Provider business mailing address

20405 VERNETTA LN
SOUTH CHESTERFIELD VA
23803-8235
US

V. Phone/Fax

Practice location:
  • Phone: 804-551-0796
  • Fax: 804-988-5466
Mailing address:
  • Phone: 804-551-0796
  • Fax: 804-988-5466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904012599
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: