Individual provider Active NPI

Christy Walker, M.A., L.P.C.

  • Counselor
  • Portage, MI
National Provider Identifier
1659780476
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401014030 Issued in MI
Practice address
1595 W Centre Ave Ste 102
Portage, MI 49024-5341
Phone
(269) 246-2458
Fax
(269) 246-2460
NPI assigned
Aug 6, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401014030 MI Primary

Addresses

Primary practice location

1595 W Centre Ave Ste 102
Portage, MI 49024-5341

Mailing address

PO Box 1792
Portage, MI 49081-1792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240117004034 MI Practitioner - Mental Health Counselor 3779935515 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6401014030MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
River of Life Counseling LLC Counselor CurrentSince Jan 1, 2024 Accepting new patients

Locations

1595 W Centre Ave
Ste 102
Portage, MI 49024
Phone (269) 246-2458

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1659780476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1792",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490811792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 W CENTRE AVE STE 102",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245341",
            "telephone_number": "269-246-2458",
            "fax_number": "269-246-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "CHRISTY",
        "credential": "M.A., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401014030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.