Provider Demographics
NPI:1689982241
Name:WALKER-BARNES, CHANEQUA JAPHETTE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHANEQUA
Middle Name:JAPHETTE
Last Name:WALKER-BARNES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 CROSSVIEW LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6728
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5315 HIGHGATE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6623
Practice Address - Country:US
Practice Address - Phone:919-418-1718
Practice Address - Fax:919-794-5715
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2828103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC60000453Medicaid
NC046FTOtherBCBSNC