Individual provider Active NPI

Jennifer E Walker, MHP

  • Mental Health Counselor
  • Goose Creek, SC
National Provider Identifier
1760720486
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SC-7199 Issued in SC
Practice address
105 Central Ave Ste 200-B
Goose Creek, SC 29445-3084
Phone
(843) 619-7892
NPI assigned
Jan 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X SC-7199 SC Primary

Addresses

Primary practice location

105 Central Ave Ste 200-B
Goose Creek, SC 29445-3084

Mailing address

431 Saint James Ave Ste L-167
Goose Creek, SC 29445-2768
Phone (843) 619-7892

Other identifiers 1

IdentifierTypeStateIssuer
1760596480MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250417001055 SC Practitioner - Mental Health Counselor 3274058706 Reassigns benefits to 1 organization
I20250417001294 NC Practitioner - Mental Health Counselor 3274058706 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC-7199SCMDMental Health Counselor
20934NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Jan 14, 2025 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients
Berkeley Community Mental Health Center Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

170 Meeting St
Ste 110
Charleston, SC 29401
Phone (704) 610-1304

Organizations & group practices 3

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": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1760720486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 SAINT JAMES AVE STE L-167",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294452768",
            "telephone_number": "843-619-7892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CENTRAL AVE STE 200-B",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294453084",
            "telephone_number": "843-619-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "MHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-31",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "SC-7199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760596480",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

Verify at the official NPI Registry.