Provider Demographics
NPI:1659824902
Name:WALKER, TAYLOR M (LCSW, LCAS)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:M
Last Name:WALKER
Suffix:
Gender:F
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5016 WOODVIEW LN
Mailing Address - Street 2:
Mailing Address - City:WEDDINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28104-8057
Mailing Address - Country:US
Mailing Address - Phone:704-776-5954
Mailing Address - Fax:
Practice Address - Street 1:5016 WOODVIEW LN
Practice Address - Street 2:
Practice Address - City:WEDDINGTON
Practice Address - State:NC
Practice Address - Zip Code:28104-8057
Practice Address - Country:US
Practice Address - Phone:704-776-5954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22507101YA0400X
NCC0115461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)