Calvin Detrick Walker Sr., MA, LPCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A11880 Issued in NC

Practice address

119 West Ave
Kannapolis, NC 28081-4332

Phone

(704) 630-6634

NPI assigned

Jan 26, 2016

Last updated

Apr 20, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Your Highnes: Clinical Services and Wholistic Healing PLLC

  • Mental Health Counselor
  • Concord, NC
  • NPI 1073219275
  NPD Authorized official

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1467819177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 CRANDON DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282162790",
            "telephone_number": "704-533-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 WEST AVE",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280814332",
            "telephone_number": "704-630-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "CALVIN",
        "middle_name": "DETRICK",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "MA, LPCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "A11880",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "A11880",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A11880",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A11880",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "A11880",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)
• Walgreen Co (Rite Aid)
• Walgreen Co (Rite Aid)
• Walgreen Co (Walgreens #04871)
• Walgreen Co (Walgreens #15253)
• Cynthia Sue Walker, R.D.
• Cedric R Waller
• Linda Jean Wanner, N.P.
• Ann Beaver Ware, LPN
• Moses Washington Jr., P-LCSW

• Mental Health Counselor in Kannapolis, NC
• Providers in Kannapolis, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; 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.