Provider Demographics
NPI:1073170403
Name:WALKER, NEASHA (LPCA)
Entity Type:Individual
Prefix:
First Name:NEASHA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:NEASHA
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NEASHA WALKER, LCMHC
Mailing Address - Street 1:965 PEACHTREE MEADOWS CIR
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-9056
Mailing Address - Country:US
Mailing Address - Phone:336-772-3389
Mailing Address - Fax:
Practice Address - Street 1:2915 COTTAGE PL APT H
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2335
Practice Address - Country:US
Practice Address - Phone:336-772-3389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-21
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YM0800X
NC14928101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty