Individual provider Active NPI

Tawana Cherise Walker, LCMHC, NCC

  • Professional Counselor
  • Gastonia, NC
National Provider Identifier
1205313749
Registry record updated Mar 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
14039 Issued in NC
Practice address
635 Cox Rd Ste B
Gastonia, NC 28054
Phone
(704) 691-7561
NPI assigned
Jul 27, 2018
Last updated
Mar 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A14039 NC
Professional Counselor 101YP2500X 14039 NC Primary

Addresses

Primary practice location

635 Cox Rd Ste B
Gastonia, NC 28054

Mailing address

1319 Park LN
Gastonia, NC 28052-0722
Phone (803) 627-0374

Other practice location 1

1319 Park Ln
Gastonia, NC 28052-0722
Phone (803) 627-0374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20250618003392 NC Practitioner - Mental Health Counselor 0143731802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

110 N Corcoran St
Durham, NC 27701-5015
Phone (323) 205-7088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14039NCMDProfessional Counselor
A14039NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Professional CurrentSince May 26, 2025 Accepting new patients
Rize Counseling Services PLLC Professional CurrentSince Mar 26, 2023 Accepting new patients
Gaston Adolescent Center, Inc. Professional Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679097600000",
    "number": "1205313749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 PARK LN",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280520722",
            "telephone_number": "803-627-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 COX RD STE B",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28054",
            "telephone_number": "704-691-7561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1319 Park Ln",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280520722",
            "country_code": "US",
            "telephone_number": "803-627-0374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "TAWANA",
        "middle_name": "CHERISE",
        "name_prefix": "Mrs.",
        "credential": "LCMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-27",
        "last_updated": "2023-03-18",
        "certification_date": "2023-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A14039",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "14039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.