Jerrell Walker, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

007754 Issued in GA

Practice address

2090 Sugarloaf Pkwy Ste 115
Lawrenceville, GA 30045-9402

Phone

(770) 658-4833

NPI assigned

Oct 8, 2014

Last updated

Dec 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Atlanta Counseling & Diagnotics Center LLC

  • Professional Counselor
  • Lawrenceville, GA
  • NPI 1265825566
  NPD Authorized official

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1083017743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 SUGARLOAF PKWY STE 115",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300459402",
            "telephone_number": "770-676-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 SUGARLOAF PKWY STE 115",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300459402",
            "telephone_number": "770-658-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JERRELL",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-08",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "007754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003153183B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debbie Smith Walker, RNFA
• Elizabeth A Walker, CRNA
• Eseosa Guobadia Walker, DPT
• Gianina Walker
• Jackqueline Walker, LPN
• Kimberly Walker
• La'Mar Walker, LPC
• Mary Emily Walker I, R.N.
• Whitney Walker
• Alexa Royal Wall

• Professional Counselor in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; 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.