Individual provider Active NPI

Jennifer Walker, LPC

  • Behavior Analyst
  • Dallas, TX
National Provider Identifier
1346662772
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
PO Box 670296
Dallas, TX 75267-0296
Phone
(580) 565-0114
NPI assigned
Jan 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

PO Box 670296
Dallas, TX 75267-0296

Mailing address

PO Box 670296
Dallas, TX 75267-0296
Phone (580) 565-0114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20240102003789 OK Practitioner - Mental Health Counselor 8527418524 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Behavioral Wellness Centers CurrentSince Jan 1, 2024 Accepting new patients
Lighthouse Behavioral Wellness Centers CurrentSince Jan 1, 2024 Accepting new patients

Locations

2530 S Commerce St
Bldg B
Ardmore, OK 73401
Phone (580) 319-7305

1001 W Main St
Durant, OK 74701
Phone (580) 924-7330

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": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1346662772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670296",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752670296",
            "telephone_number": "580-565-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 670296",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752670296",
            "telephone_number": "580-565-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JENNIFER",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.