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General NPI Number Information
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NPI Number | 1386341824
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Entity Type | Individual
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Provider Name | MR. DARRYL WALKER JR.
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Gender | Male
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Dates
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Enumeration Date | 02/15/2023
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 1052 PARK AVE
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City | CRANSTON
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State | RI
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Zip | 02910-3225
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Country | US
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Telephone | 401-461-5056
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Fax |
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Provider Business Mailing Address
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Address Line | 65 ROSE ST
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-5018
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Country | US
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Telephone | 401-996-6239
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 21382
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDP00873
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License Number State | RI
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