Provider Demographics
NPI:1760893242
Name:WALKER, CHRISTINA DIANNE (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:DIANNE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:DIANNE
Other - Last Name:STANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:602 STRADA CIRCLE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3201
Mailing Address - Country:US
Mailing Address - Phone:682-365-9290
Mailing Address - Fax:819-930-9059
Practice Address - Street 1:602 STRADA CIR
Practice Address - Street 2:SUITE 118
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3201
Practice Address - Country:US
Practice Address - Phone:682-365-9290
Practice Address - Fax:817-529-5741
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-18
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69727101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional