Provider Demographics
NPI:1548080237
Name:ALICE WALKER LPCC, INC.
Entity type:Organization
Organization Name:ALICE WALKER LPCC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-439-6410
Mailing Address - Street 1:11603 ROAD 27.3
Mailing Address - Street 2:
Mailing Address - City:DOLORES
Mailing Address - State:CO
Mailing Address - Zip Code:81323-9249
Mailing Address - Country:US
Mailing Address - Phone:502-439-6410
Mailing Address - Fax:
Practice Address - Street 1:11603 ROAD 27.3
Practice Address - Street 2:
Practice Address - City:DOLORES
Practice Address - State:CO
Practice Address - Zip Code:81323-9249
Practice Address - Country:US
Practice Address - Phone:502-439-6410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty