Walker Edmondson, ALC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

ALC04665 Issued in AL

Practice address

1000 Lincoln Ave Ste 500
Oneonta, AL 35121-2537

Phone

(888) 355-7080

Fax

(256) 615-8632

NPI assigned

Oct 24, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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 and National Provider Directory roles.

• Yellow Brick Road Counseling, LLC

  • Mental Health Counselor
  • Cullman, AL
  • NPI 1750863460
  NPD

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1316719396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1324",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350561324",
            "telephone_number": "888-355-7080",
            "fax_number": "256-615-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LINCOLN AVE STE 500",
            "city": "ONEONTA",
            "state": "AL",
            "postal_code": "351212537",
            "telephone_number": "888-355-7080",
            "fax_number": "256-615-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "WALKER",
        "credential": "ALC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AL",
            "license": "ALC04665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eastside Ventures, Inc.
• Katie Entrekin, M.S., OTR/L
• Evergreen Medical Cosmetic Laser Center
• Evi Physician Services I, LLC
• Express Care Clinic of Oneonta, P.C.
• Janna Faust, RPH

• All providers in Oneonta, AL
• Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.