Provider Demographics
NPI:1922276526
Name:WALKER, LINDA M (LCPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:WALKER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:845 W CENTER ST STE C
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-4237
Mailing Address - Country:US
Mailing Address - Phone:208-232-2846
Mailing Address - Fax:208-232-8001
Practice Address - Street 1:845 W CENTER ST STE C
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83204-4237
Practice Address - Country:US
Practice Address - Phone:208-232-2846
Practice Address - Fax:208-232-8001
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-145101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health