Individual provider Active NPI

Elena Faith Walker, M.A., LPCC

  • Counselor
  • Saint Paul, MN
National Provider Identifier
1417396409
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CC00399 Issued in MN
Practice address
1061 Grand Ave
Saint Paul, MN 55105-3002
Phone
(651) 212-4920
Fax
(651) 212-4795
NPI assigned
Jun 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CC00399 MN Primary

Addresses

Primary practice location

1061 Grand Ave
Saint Paul, MN 55105-3002

Mailing address

3617 34TH Ave S
Minneapolis, MN 55406-2734
Phone (612) 723-2103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20240111002815 MN Practitioner - Mental Health Counselor 4284085416 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CC00399MNMDCounselor
399MNMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Wild Tree Psychotherapy, LLC CurrentSince Jan 1, 2024 Accepting new patients
Sarah C. Chambers, P.a. PastSince Jan 1, 2024 Accepting new patients

Locations

1061 Grand Ave
Saint Paul, MN 55105
Phone (612) 271-6807

653 Grand Ave
Saint Paul, MN 55105
Phone (651) 212-4920

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": "1371945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1417396409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 34TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062734",
            "telephone_number": "612-723-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053002",
            "telephone_number": "651-212-4920",
            "fax_number": "651-212-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "ELENA",
        "middle_name": "FAITH",
        "credential": "M.A., LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-23",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "CC00399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.