Provider Demographics
NPI:1326707209
Name:WALKER, KRISTY LYNN (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:LYNN
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 W STATE ST STE 302
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24201-3823
Mailing Address - Country:US
Mailing Address - Phone:276-409-9083
Mailing Address - Fax:276-444-8821
Practice Address - Street 1:1009 W STATE ST STE 302
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-3823
Practice Address - Country:US
Practice Address - Phone:276-696-1799
Practice Address - Fax:276-444-8821
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010872101YP2500X
TN5982101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional