Breanna M Walker

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

4907 Highway 84 W
Vidalia, LA 71373-3579

Phone

(318) 414-3065

Fax

(318) 414-3067

NPI assigned

Jan 26, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Bruce Professional Counseling

  • Community/Behavioral Health Agency
  • Vidalia, LA
  • NPI 1255799235
  NPD (past)

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1184081853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391210073",
            "telephone_number": "702-308-7682",
            "fax_number": "318-414-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4907 HIGHWAY 84 W",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713733579",
            "telephone_number": "318-414-3065",
            "fax_number": "318-414-3067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Hudson Ln",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712016068",
            "country_code": "US",
            "telephone_number": "318-437-7157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "BREANNA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wal-Mart Stores East LP
• Warshaw Chiropractic Clinic LLC
• Monty Roy Warshaw, D.C.
• Ladonna Kay Washington-Harper
• Norvell Lashawn Watts
• Abby Webb

• Case Manager/Care Coordinator in Vidalia, LA
• Providers in Vidalia, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.