Provider Demographics
NPI:1427098045
Name:WALKER, HARRIET I (PHD, CADC-III, NCGC)
Entity type:Individual
Prefix:
First Name:HARRIET
Middle Name:I
Last Name:WALKER
Suffix:
Gender:F
Credentials:PHD, CADC-III, NCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WOODRUFF
Mailing Address - State:WI
Mailing Address - Zip Code:54568-0470
Mailing Address - Country:US
Mailing Address - Phone:715-356-8000
Mailing Address - Fax:
Practice Address - Street 1:311 ELM ST
Practice Address - Street 2:
Practice Address - City:WOODRUFF
Practice Address - State:WI
Practice Address - Zip Code:54568-9149
Practice Address - Country:US
Practice Address - Phone:715-356-8540
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11530101YA0400X
WI2359-057103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43565100Medicaid
WI43565100Medicaid