Justin Mansfield Walker, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.176467 Issued in OH

Practice address

214 S 4TH St
Ironton, OH 45638-1610

Phone

(740) 532-3767

Fax

(740) 532-3385

NPI assigned

Nov 15, 2021

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.

• Spectrum Outreach Services, LTD

  • Community/Behavioral Health Agency
  • Ironton, OH
  • NPI 1013969666

  Addiction (Substance Use Disorder)

  NPD
• Spectrum Outreach Services, LTD

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ironton, OH
  • NPI 1699254300
  NPD (past)

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1497411433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 S 4TH ST",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456381610",
            "telephone_number": "740-532-3767",
            "fax_number": "740-532-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 S 4TH ST",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456381610",
            "telephone_number": "740-532-3767",
            "fax_number": "740-532-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JUSTIN",
        "middle_name": "MANSFIELD",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.176467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Collins Wagner, FNP
• Donna Wagner
• Jessecca Louise Walcott
• Walgreen Co
• Chelsea Walker
• Carolyn Theresa Marie Wallace
• Terri Lynn Wallace, CDCA,QMHS
• Justin Walters, PRS
• Ryan Andrew Warren
• Donald Washburn

• Addiction (Substance Use Disorder) Counselor in Ironton, OH
• Providers in Ironton, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.