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General NPI Number Information
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NPI Number | 1104740810
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Entity Type | Individual
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Provider Name | BEVERLY MICHELLE WALKER LPC
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Gender | Female
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 3517 TRYON RD
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City | LONGVIEW
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State | TX
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Zip | 75605-8310
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Country | US
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Telephone | 903-252-4673
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Fax |
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Provider Business Mailing Address
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Address Line | 5805 FM 3358
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City | GILMER
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State | TX
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Zip | 75645-8270
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Country | US
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Telephone | 903-932-9233
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 83584
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License Number State | TX
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