Provider Demographics
NPI:1003565722
Name:WALKER, JAMIE E (AAS, PLADC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:E
Last Name:WALKER
Suffix:
Gender:M
Credentials:AAS, PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 S 42ND ST STE 538
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2945
Mailing Address - Country:US
Mailing Address - Phone:402-504-3242
Mailing Address - Fax:
Practice Address - Street 1:1941 S 42ND ST STE 538
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2945
Practice Address - Country:US
Practice Address - Phone:402-504-3242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-1820101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)