Individual provider Active NPI

William Walker, L.M.H.C.

  • Mental Health Counselor
  • Palm Bay, FL
National Provider Identifier
1790700706
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH0002552 Issued in FL
Practice address
2123 Franklin Dr NE
Palm Bay, FL 32905-4022
Phone
(321) 724-1614
Fax
(321) 722-3590
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH0002552 FL Primary

Addresses

Primary practice location

2123 Franklin Dr NE
Palm Bay, FL 32905-4022

Mailing address

2123 Franklin Dr NE
Palm Bay, FL 32905-4022
Phone (321) 724-1614

Other identifiers 1

IdentifierTypeStateIssuer
Z4396OtherFLBLUE CROSS BLUE SHIELD

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH0002552FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Psychiatric Centers, Inc. Mental Health PastSince Jan 24, 1997 Accepting new patients

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790700706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 FRANKLIN DR NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329054022",
            "telephone_number": "321-724-1614",
            "fax_number": "321-722-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 FRANKLIN DR NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329054022",
            "telephone_number": "321-724-1614",
            "fax_number": "321-722-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "WILLIAM",
        "credential": "L.M.H.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH0002552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Z4396",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.