Provider Demographics
NPI:1275026437
Name:WALKER, JENNIFER WINIFRED (LPC, CSAC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:WINIFRED
Last Name:WALKER
Suffix:
Gender:
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MAIN ST STE 305
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-4019
Mailing Address - Country:US
Mailing Address - Phone:608-284-8512
Mailing Address - Fax:855-232-9158
Practice Address - Street 1:401 MAIN ST STE 305
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-4019
Practice Address - Country:US
Practice Address - Phone:608-620-3909
Practice Address - Fax:855-232-9158
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-12
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16031101YA0400X
WI8402101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)