Provider Demographics
NPI:1134848807
Name:WALKER, XAVIER JR (LMHC)
Entity type:Individual
Prefix:
First Name:XAVIER
Middle Name:
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2456 BASELINE RD APT 6
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-1642
Mailing Address - Country:US
Mailing Address - Phone:718-427-8286
Mailing Address - Fax:
Practice Address - Street 1:2456 BASELINE RD APT 6
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NY
Practice Address - Zip Code:14072-1642
Practice Address - Country:US
Practice Address - Phone:718-427-8286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY011855101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health