Provider Demographics
NPI:1316335607
Name:WALKER, VANESSA (MMFT, LPC-MHSP)
Entity type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:MMFT, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WOODS LAKE RD STE 600
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2766
Mailing Address - Country:US
Mailing Address - Phone:864-383-9002
Mailing Address - Fax:864-383-9011
Practice Address - Street 1:25 WOODS LAKE RD STE 600
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2766
Practice Address - Country:US
Practice Address - Phone:864-383-9002
Practice Address - Fax:864-383-9011
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3300101YP2500X
SC7950101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional