Active NPI
Michelle Nicole Walker, PSY.D.
- Psychologist
- Rockville, MD
National Provider Identifier
1669672978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 06191
- Practice address
- 9707 Key West Ave Ste 100
Rockville, MD 20850-3992 - Phone
- (240) 750-6467
- Fax
- (240) 702-0262
- NPI assigned
- Jul 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 25670 | CA | |
| Psychologist | 103T00000X | 06191 | MD | Primary |
Addresses
Primary practice location
9707 Key West Ave Ste 100
Rockville, MD 20850-3992
Mailing address
9707 Key West Ave Ste 100
Rockville, MD 20850-3992
Phone (240) 750-6467
Other practice location 1
823 Gateway Center Way
Suite 116
San Diego, CA 92102-4541
Phone (619) 906-4623
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06191 | Other | MD | PSYCHOLOGIST LICENSE |
| 25670 | Other | CA | LIC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563753600000",
"number": "1669672978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9707 KEY WEST AVE STE 100",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208503992",
"telephone_number": "240-750-6467",
"fax_number": "240-702-0262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9707 KEY WEST AVE STE 100",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208503992",
"telephone_number": "240-750-6467",
"fax_number": "240-702-0262"
}
],
"practiceLocations": [
{
"address_1": "823 GATEWAY CENTER WAY",
"address_2": "Suite 116",
"address_purpose": "LOCATION",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921024541",
"country_code": "US",
"telephone_number": "619-906-4623",
"fax_number": "619-906-4564",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALKER",
"first_name": "MICHELLE",
"middle_name": "NICOLE",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-24",
"last_updated": "2019-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "25670",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "06191",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGIST LICENSE",
"identifier": "06191",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIC",
"identifier": "25670",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.