Provider Demographics
NPI:1225637572
Name:WALKER, CAROLYN (MSN, LPC, RN-BC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:MSN, LPC, RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4746 RAVEN RUN
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-4636
Mailing Address - Country:US
Mailing Address - Phone:816-679-5008
Mailing Address - Fax:
Practice Address - Street 1:8805 W 14TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-4848
Practice Address - Country:US
Practice Address - Phone:855-908-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0013389101Y00000X
MO2016030203101Y00000X
CORN.1619084163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No101Y00000XBehavioral Health & Social Service ProvidersCounselor