Provider Demographics
NPI:1346652153
Name:WALKER, KRISTIN MICHELLE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MICHELLE
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 1:7720 W GOOD HOPE RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-4516
Mailing Address - Country:US
Mailing Address - Phone:414-536-0236
Mailing Address - Fax:
Practice Address - Street 1:7720 W GOOD HOPE RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-4516
Practice Address - Country:US
Practice Address - Phone:414-536-0236
Practice Address - Fax:414-536-0260
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-28
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100038103Medicaid