MEDICARE: MS. CARRIE JEAN WALKER MS, LPC, RPT-S, CTP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0701004199	VA

General Provider Information

NPI Number	:	1407047004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARRIE JEAN WALKER MS, LPC, RPT-S, CTP

Provider Business Mailing Address
First Line	:	1900 BYRD AVE
Second Line	:	SUITE 200
City	:	RICHMOND
State	:	VA
Zip	:	23230-3033
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 BYRD AVE
Second Line	:	SUITE 200
City	:	RICHMOND
State	:	VA
Zip	:	23230-3033
Country	:	US
Telephone Number	:	804-592-6311
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2007
Last Update Date	:	07/01/2016

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