MEDICARE: DIAMOND WALKER M.A, L.P.C, C-D.B.T

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	101Y00000X	Counselor	85212	TX
2	171M00000X	Case Manager/Care Coordinator
3	101YP2500X	Professional Counselor	85212	TX
4	101YM0800X	Mental Health Counselor	85212	TX
5	101YP1600X	Pastoral Counselor

General Provider Information

NPI Number	:	1578076881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIAMOND WALKER M.A, L.P.C, C-D.B.T

Provider Business Mailing Address
First Line	:	4101 MCEWEN RD STE 346
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5276
Country	:	US
Telephone Number	:	214-336-4417
Fax Number	:	214-377-6247

Provider Business Practice Location Address
First Line	:	4101 MCEWEN RD STE 346
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5276
Country	:	US
Telephone Number	:	214-336-4417
Fax Number	:	214-377-6247

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

Provider Enumeration Date	:	11/08/2017
Last Update Date	:	01/22/2026

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