Provider Demographics
NPI:1073657227
Name:WALKER, BEN W (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:BEN
Middle Name:W
Last Name:WALKER
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 29TH DR
Mailing Address - Street 2:STE D
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-2612
Mailing Address - Country:US
Mailing Address - Phone:806-773-9480
Mailing Address - Fax:806-798-8666
Practice Address - Street 1:5120 29TH DR
Practice Address - Street 2:STE D
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-2612
Practice Address - Country:US
Practice Address - Phone:806-773-9480
Practice Address - Fax:806-798-8666
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13694907101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179795301Medicaid
TX7302LCOtherBCBSTX PROVIDER #