Provider Demographics
NPI:1215358296
Name:WALKER, BRENDA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
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 1:236 N MEBANE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-3955
Mailing Address - Country:US
Mailing Address - Phone:336-436-0074
Mailing Address - Fax:336-436-0232
Practice Address - Street 1:236 N MEBANE ST STE 101
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-3966
Practice Address - Country:US
Practice Address - Phone:336-436-0074
Practice Address - Fax:336-436-0232
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8375101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional