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General NPI Number Information
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NPI Number | 1861851354
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Entity Type | Organization
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Legal Business Name | NELSIE WALKER, PA
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Dates
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Enumeration Date | 02/12/2016
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Last Update Date | 02/12/2016
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Provider Practice Location Address
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Address Line | 3501 CORTEZ RD W MAIN LOBBY
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City | BRADENTON
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State | FL
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Zip | 34210-3104
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Country | US
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Telephone | 941-795-7330
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Fax | 941-795-0181
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Provider Business Mailing Address
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Address Line | 5726 CORTEZ RD W A-1
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City | BRADENTON
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State | FL
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Zip | 34210-2701
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Country | US
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Telephone | 941-812-3977
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Fax | 941-795-0181
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. NELSIE ENEIDA WALKER
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Credential | LMHC, CAP, DOT-SAP
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Telephone | 941-812-3977
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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 | CAP #1489
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LMHC #0003538
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License Number State | FL
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