Individual provider Active NPI

Michael Joseph Walker

  • Mental Health Counselor
  • Nome, AK
National Provider Identifier
1083838379
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
607 Division St.
Nome, AK 99762
Phone
(907) 443-3344
Fax
(907) 443-5915
NPI assigned
Apr 11, 2007
Reactivated
Aug 8, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 45915 CA
Student in an Organized Health Care Education/Training Program 390200000X MFC45915 CA
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

607 Division St.
Nome, AK 99762

Mailing address

607 Division St.
Nome, AK 99762
Phone (907) 443-3344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251009003005 CA Practitioner - Marriage and Family Therapist 4688171150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

120 Stony Point Rd
Suite 200
Santa Rosa, CA 95401-4132

PO Box
Suite 1178
Guerneville, CA 95446-1178

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC 45915CAMDMarriage & Family Therapist
MFC45915CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Community Health Centers CurrentSince Sep 26, 2025 Accepting new patients
Santa Rosa Community Health Centers CurrentSince Sep 26, 2025 Accepting new patients

Locations

3569 Round Barn Cir
Santa Rosa, CA 95403

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1083838379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 DIVISION ST.",
            "city": "NOME",
            "state": "AK",
            "postal_code": "99762",
            "telephone_number": "907-443-3344",
            "fax_number": "907-443-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 DIVISION ST.",
            "city": "NOME",
            "state": "AK",
            "postal_code": "99762",
            "telephone_number": "907-443-3344",
            "fax_number": "907-443-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2018-07-05",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2008-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 45915",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "MFC45915",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nome, AK

Sources for this page

Verify at the official NPI Registry.