Provider Demographics
NPI:1982971974
Name:WALKER, SHATANYA L (LPC, CRC)
Entity type:Individual
Prefix:
First Name:SHATANYA
Middle Name:L
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1076 HWY 86
Mailing Address - Street 2:
Mailing Address - City:YANCEYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27379
Mailing Address - Country:US
Mailing Address - Phone:336-694-1487
Mailing Address - Fax:336-694-1681
Practice Address - Street 1:335 COUNTY HOME RD.
Practice Address - Street 2:
Practice Address - City:WENTWORTH
Practice Address - State:NC
Practice Address - Zip Code:27375
Practice Address - Country:US
Practice Address - Phone:336-342-5756
Practice Address - Fax:336-349-1115
Is Sole Proprietor?:No
Enumeration Date:2011-11-19
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10158101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor