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General NPI Number Information
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NPI Number | 1134639875
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Entity Type | Individual
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Provider Name | SHELTON WALKER LPC
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Gender | Male
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Dates
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Enumeration Date | 10/09/2017
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 420 W. FOURTH STREET, SUITE A
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114
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Country | US
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Telephone | 501-408-3431
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 RICHARDS RD
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72117-2954
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Country | US
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Telephone | 501-221-1843
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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 | P2209004
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License Number State | AR
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