Provider Demographics
NPI:1538791645
Name:WALKER, JAMIA RACHELLE (LCPC)
Entity type:Individual
Prefix:MS
First Name:JAMIA
Middle Name:RACHELLE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22407 LAWNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471-2044
Mailing Address - Country:US
Mailing Address - Phone:773-634-0958
Mailing Address - Fax:
Practice Address - Street 1:19831 GOVERNORS HWY
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2001
Practice Address - Country:US
Practice Address - Phone:708-960-0907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011561101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional