Provider Demographics
NPI:1750872974
Name:WALKER, LEAH (LPC-MHSP, NCC)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPC-MHSP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 OLD TIMBER RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-9514
Mailing Address - Country:US
Mailing Address - Phone:615-787-8775
Mailing Address - Fax:
Practice Address - Street 1:1501 WILLIAM C. LEE ROAD
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223
Practice Address - Country:US
Practice Address - Phone:615-787-8775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4129101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional