Provider Demographics
NPI:1306344866
Name:WALKER, STEPHANIE (LPC-INTERN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 FOUNTAIN VIEW DR APT 130
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-2445
Mailing Address - Country:US
Mailing Address - Phone:713-703-4589
Mailing Address - Fax:
Practice Address - Street 1:11999 KATY FWY STE 490
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1608
Practice Address - Country:US
Practice Address - Phone:713-365-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77232101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor