Individual provider Active NPI

Kenneth Tyrone Walker, LPC, M.S., M.ED.

  • Professional Counselor
  • Albany, GA
National Provider Identifier
1063820967
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC008176 Issued in GA
Practice address
127 Autumn Leaf Dr
Albany, GA 31701-4799
Phone
(478) 294-9521
NPI assigned
Jul 24, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC008176 GA Primary

Addresses

Primary practice location

127 Autumn Leaf Dr
Albany, GA 31701-4799

Mailing address

127 Autumn Leaf Dr
Albany, GA 31701-4799
Phone (478) 294-9521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education, Master of Science

State licenses

LicenseStateTypeSpecialty
LPC008176GAMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1063820967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 AUTUMN LEAF DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317014799",
            "telephone_number": "478-294-9521",
            "fax_number": "229-352-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 AUTUMN LEAF DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317014799",
            "telephone_number": "478-294-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KENNETH",
        "middle_name": "TYRONE",
        "credential": "LPC, M.S., M.ED.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.