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General NPI Number Information
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NPI Number | 1760024335
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Entity Type | Organization
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Legal Business Name | WALKER COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 12/12/2019
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Provider Practice Location Address
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Address Line | 208 SHOPPINGWAY BLVD STE E
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-1734
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Country | US
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Telephone | 901-262-9102
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 JOHN MICHAEL DR
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City | SOUTHAVEN
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State | MS
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Zip | 38672-8515
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Country | US
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Telephone | 870-636-1719
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER WALKER
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Credential | LPC
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Telephone | 870-636-1719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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