Provider Demographics
NPI:1396211942
Name:WALKER, AIMEE SUSAN (LPC)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:SUSAN
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 1:100 NW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:OK
Mailing Address - Zip Code:73065-6248
Mailing Address - Country:US
Mailing Address - Phone:405-387-3838
Mailing Address - Fax:405-387-3822
Practice Address - Street 1:100 NW 16TH ST
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:OK
Practice Address - Zip Code:73065-6248
Practice Address - Country:US
Practice Address - Phone:405-387-3838
Practice Address - Fax:405-387-3822
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OK10322101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator