Active NPI
Theolyn Walker, LCPC
- Professional Counselor
- Clinton, MD
National Provider Identifier
1639565310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC4070
- Practice address
- 6368 Coventry Way Ste 265
Clinton, MD 20735-2256 - Phone
- (410) 893-4600
- NPI assigned
- Apr 9, 2015
- Last updated
- Jan 4, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC4070 | MD | Primary |
Addresses
Primary practice location
6368 Coventry Way Ste 265
Clinton, MD 20735-2256
Mailing address
6368 Coventry Way Ste 265
Clinton, MD 20735-2256
Phone (410) 893-4600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2005
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC4070 | MD | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Professional | Current | Accepting new patients |
| Gateway to Resilience Counseling Services | Current | Accepting new patients |
Locations
8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Clinton, MD
- NPI 1811648561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451865600000",
"number": "1639565310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6368 COVENTRY WAY STE 265",
"city": "CLINTON",
"state": "MD",
"postal_code": "207352256",
"telephone_number": "410-893-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6368 COVENTRY WAY STE 265",
"city": "CLINTON",
"state": "MD",
"postal_code": "207352256",
"telephone_number": "410-893-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "THEOLYN",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-09",
"last_updated": "2016-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC4070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.