Provider Demographics
NPI:1861599409
Name:WALKER, NELSIE ENEIDA (LMHC,CAP,DOT/SAP)
Entity type:Individual
Prefix:MS
First Name:NELSIE
Middle Name:ENEIDA
Last Name:WALKER
Suffix:
Gender:F
Credentials:LMHC,CAP,DOT/SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5726 CORTEZ RD W
Mailing Address - Street 2:#260
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-2701
Mailing Address - Country:US
Mailing Address - Phone:941-812-3977
Mailing Address - Fax:
Practice Address - Street 1:3633 CORTEZ RD W
Practice Address - Street 2:STEPPING STONE CLINIC (STE A-9)
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3119
Practice Address - Country:US
Practice Address - Phone:941-812-3977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1489101YA0400X
FL0003538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health