Provider Demographics
NPI:1821360264
Name:WALKER, STEPHEN (MHPP)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 CENTRAL AVE STE D
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-6898
Mailing Address - Country:US
Mailing Address - Phone:501-463-4627
Mailing Address - Fax:501-463-4629
Practice Address - Street 1:1820 CENTRAL AVE STE D
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6898
Practice Address - Country:US
Practice Address - Phone:501-663-5473
Practice Address - Fax:501-801-1816
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
P1608121101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP1608121OtherARKANSAS BOARD OF EXAMINERS IN COUNSELING
AR201083795Medicaid
AR1821360264Medicaid