Provider Demographics
NPI:1902201882
Name:WALKER, THOMAS JAMES JR
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JAMES
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:THOMAS
Other - Middle Name:JAMES
Other - Last Name:WALKER
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:BS
Mailing Address - Street 1:2901 W OAKLAND PARK BLVD STE A1-A2
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1243
Mailing Address - Country:US
Mailing Address - Phone:954-202-9334
Mailing Address - Fax:
Practice Address - Street 1:2901 W OAKLAND PARK BLVD STE A1-A2
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1243
Practice Address - Country:US
Practice Address - Phone:954-202-9334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist