Individual provider Active NPI

Keri Ann Walker, LPC

  • Professional Counselor
  • Erie, PA
National Provider Identifier
1487280665
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC005852 Issued in PA
Practice address
1330 W 26TH St
Erie, PA 16508-1402
Phone
(814) 459-9300
Fax
(814) 454-7780
NPI assigned
Mar 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC005852 PA Primary

Addresses

Primary practice location

1330 W 26TH St
Erie, PA 16508-1402

Mailing address

1330 W 26TH St
Erie, PA 16508-1402
Phone (814) 459-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240422003309 PA Practitioner - Mental Health Counselor 1254770316 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Medical PCGroup PAC ID 4082089461, 64 clinicians

Practice addresses (Care Compare)

4203 Union Deposit Rd
Suite 1098
Harrisburg, PA 17111-2802
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC005852PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Metanoia Counseling & Professional Development Services LLC CurrentSince Jan 28, 2024 Accepting new patients
Brightside Medical, P.C. CurrentSince Apr 1, 2024 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

4203 Union Deposit Rd
Harrisburg, PA 17111
Phone (223) 797-7187

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1487280665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081402",
            "telephone_number": "814-459-9300",
            "fax_number": "814-454-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081402",
            "telephone_number": "814-459-9300",
            "fax_number": "814-454-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KERI",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC005852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.