Provider Demographics
NPI:1760720973
Name:WALKER, ANGELINE STEPHANIE (MS, LPCA)
Entity Type:Individual
Prefix:MRS
First Name:ANGELINE
Middle Name:STEPHANIE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MS, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12106 DOWNY BIRCH RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-3672
Mailing Address - Country:US
Mailing Address - Phone:347-821-2287
Mailing Address - Fax:
Practice Address - Street 1:12106 DOWNY BIRCH RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-3672
Practice Address - Country:US
Practice Address - Phone:347-821-2287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8988101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor