Provider Demographics
NPI:1700201324
Name:WALKER, AMANDA (MHS, CRC, LAC, LPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:MHS, CRC, LAC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 TULANE AVE STE 945
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-7578
Mailing Address - Country:US
Mailing Address - Phone:503-821-2232
Mailing Address - Fax:504-822-0095
Practice Address - Street 1:2601 TULANE AVE STE 945
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7578
Practice Address - Country:US
Practice Address - Phone:504-821-2232
Practice Address - Fax:504-822-0095
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1274101YA0400X
LA4421101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)