Provider Demographics
NPI:1083950463
Name:WALKER, SHELIA DE LOIS (CADC-II)
Entity Type:Individual
Prefix:MS
First Name:SHELIA
Middle Name:DE LOIS
Last Name:WALKER
Suffix:
Gender:F
Credentials:CADC-II
Other - Prefix:MS
Other - First Name:SHELIA
Other - Middle Name:WALKER
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC-II
Mailing Address - Street 1:PO BOX 203
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31603-0203
Mailing Address - Country:US
Mailing Address - Phone:229-269-6798
Mailing Address - Fax:
Practice Address - Street 1:5624 FONTANA RD
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31601-2479
Practice Address - Country:US
Practice Address - Phone:229-269-6798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA422101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)