Provider Demographics
NPI:1760954705
Name:MISHELE WALKER LLC
Entity Type:Organization
Organization Name:MISHELE WALKER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PROFESSIONAL COUNSEL
Authorized Official - Prefix:MS
Authorized Official - First Name:MISHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:801-859-8387
Mailing Address - Street 1:329 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30354-1106
Mailing Address - Country:US
Mailing Address - Phone:801-859-8387
Mailing Address - Fax:404-459-6001
Practice Address - Street 1:555 GLENRIDGE CONNECTOR
Practice Address - Street 2:SUITE 200
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:801-859-8387
Practice Address - Fax:404-459-6001
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MISHELE WALKER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty