Provider Demographics
NPI:1265476329
Name:WALKER, BRELONDA R (LPC)
Entity Type:Individual
Prefix:MRS
First Name:BRELONDA
Middle Name:R
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1535
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-1535
Mailing Address - Country:US
Mailing Address - Phone:704-896-6044
Mailing Address - Fax:704-896-6133
Practice Address - Street 1:19824 W CATAWBA AVE
Practice Address - Street 2:SUITE G-205
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-4046
Practice Address - Country:US
Practice Address - Phone:704-896-6044
Practice Address - Fax:704-896-6133
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional