Provider Demographics
NPI:1184853525
Name:WALKER, MILLICENT FOWLER (LPC/I)
Entity Type:Individual
Prefix:MRS
First Name:MILLICENT
Middle Name:FOWLER
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPC/I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E RICHARDSON AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-6336
Mailing Address - Country:US
Mailing Address - Phone:843-875-1551
Mailing Address - Fax:843-851-5963
Practice Address - Street 1:303 E RICHARDSON AVE
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6336
Practice Address - Country:US
Practice Address - Phone:843-875-1551
Practice Address - Fax:843-851-5963
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5003101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional