Provider Demographics
NPI:1336101815
Name:WALKER, ROBERT A (PHD LMHC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:WALKER
Suffix:
Gender:M
Credentials:PHD LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1087 WARWICK AVE REAR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888
Mailing Address - Country:US
Mailing Address - Phone:401-383-2200
Mailing Address - Fax:401-256-5209
Practice Address - Street 1:1087 WARWICK AVE REAR
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888
Practice Address - Country:US
Practice Address - Phone:401-383-2200
Practice Address - Fax:401-456-5209
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00166101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor