Provider Demographics
NPI:1659422160
Name:MCKAY, WALTER (LPC)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:
Last Name:MCKAY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-3852
Mailing Address - Country:US
Mailing Address - Phone:870-425-2030
Mailing Address - Fax:870-425-7030
Practice Address - Street 1:15 E 5TH ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3809
Practice Address - Country:US
Practice Address - Phone:870-425-2030
Practice Address - Fax:870-425-7030
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0107029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional