Individual provider Active NPI

Adam Elias Stuart-Walker, MA, LPC

  • Professional Counselor
  • Cheyenne, WY
National Provider Identifier
1629444351
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-1744 Issued in WY
Practice address
1816 E 17TH St
Cheyenne, WY 82001-5010
Phone
(307) 426-4204
NPI assigned
Aug 17, 2015
Last updated
Dec 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PPC WY
Professional Counselor 101YP2500X LPC-1744 WY Primary

Addresses

Primary practice location

1816 E 17TH St
Cheyenne, WY 82001-5010

Mailing address

1816 E 17TH St
Cheyenne, WY 82001-5010
Phone (307) 426-4204

Other identifiers 1

IdentifierTypeStateIssuer
142603600MedicaidWY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adam.stuartwalker@speaklife.family SPEAK LIFE LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: No
  • 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
I20240115001741 WY Practitioner - Mental Health Counselor 4981055225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1816 E 17TH St
Cheyenne, WY 82001-5010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LPC-1744WYMDProfessional Counselor
PPCWYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Speak Life LLC CurrentSince Nov 30, 2023 Accepting new patients

Locations

1816 E 17th St
Cheyenne, WY 82001
Phone (307) 426-4204

Interoperability endpoints

  • Direct secure messaging: adam.stuartwalker@speaklife.family

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1629444351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 E 17TH ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015010",
            "telephone_number": "307-426-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 E 17TH ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015010",
            "telephone_number": "307-426-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART-WALKER",
        "first_name": "ADAM",
        "middle_name": "ELIAS",
        "name_prefix": "Mr.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-17",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "PPC",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "LPC-1744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142603600",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adam.stuartwalker@speaklife.family",
            "affiliation": "Y",
            "endpointDescription": "Provider secure email",
            "affiliationName": "SPEAK LIFE LLC",
            "address_1": "1816 E 17th St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820015010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.