Provider Demographics
NPI: | 1649291477 |
---|---|
Name: | WALKER, FRANCES J (LMHC) |
Entity type: | Individual |
Prefix: | |
First Name: | FRANCES |
Middle Name: | J |
Last Name: | WALKER |
Suffix: | |
Gender: | F |
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: | 615 12TH ST NW |
Mailing Address - Street 2: | |
Mailing Address - City: | LARGO |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33770-2363 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 727-225-2706 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 12551 INDIAN ROCKS RD STE 15 |
Practice Address - Street 2: | |
Practice Address - City: | LARGO |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33774-3009 |
Practice Address - Country: | US |
Practice Address - Phone: | 727-225-2706 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-07-21 |
Last Update Date: | 2015-11-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
GA | 1628 | 101YP2500X |
FL | LMHC 11198 | 101YM0800X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | 01649291477 | Other | PSYCHAMERICA,1009 MAITLAND CENTER COMMONS, #212, MAITLAND, FL 32751-7270 |