Active NPI
Michael Joseph Walker
- Mental Health Counselor
- Nome, AK
National Provider Identifier
1083838379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 45915 | CA | MD | Marriage & Family Therapist |
| MFC45915 | CA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santa Rosa Community Health Centers | Current | Accepting new patients | |
| Santa Rosa Community Health Centers | Current | 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.
-
- Federally Qualified Health Center (FQHC)
- Santa Rosa, CA
- NPI 1578631172
-
- Federally Qualified Health Center (FQHC)
- Santa Rosa, CA
- NPI 1467180430
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.