Provider Demographics
NPI:1598838971
Name:WALKER, MELINDA LEE (LPCC)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:LEE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 2ND ST STE 25
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-3801
Mailing Address - Country:US
Mailing Address - Phone:505-471-1244
Mailing Address - Fax:
Practice Address - Street 1:1807 2ND ST STE 25
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3801
Practice Address - Country:US
Practice Address - Phone:505-471-1244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0105401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health