Provider Demographics
NPI:1972006617
Name:WALKER, LUCUS AUSTIN (QBHP)
Entity Type:Individual
Prefix:MR
First Name:LUCUS
Middle Name:AUSTIN
Last Name:WALKER
Suffix:
Gender:M
Credentials:QBHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6266
Mailing Address - Country:US
Mailing Address - Phone:501-420-2565
Mailing Address - Fax:501-406-2878
Practice Address - Street 1:402 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-6266
Practice Address - Country:US
Practice Address - Phone:501-420-2565
Practice Address - Fax:501-406-2878
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health