Provider Demographics
NPI:1578839783
Name:WALKER, JEFFREY SCOTT (MA, NCC, MAC, LPC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:SCOTT
Last Name:WALKER
Suffix:
Gender:M
Credentials:MA, NCC, MAC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 SCALP AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-1640
Mailing Address - Country:US
Mailing Address - Phone:814-262-0007
Mailing Address - Fax:814-262-9887
Practice Address - Street 1:636 SCALP AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-1640
Practice Address - Country:US
Practice Address - Phone:814-262-0007
Practice Address - Fax:814-262-9887
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002489101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional