Active NPI
Douglas John Walker, CDP
- Counselor
- Spokane Valley, WA
National Provider Identifier
1972071199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CP00001820
- Practice address
- 12715 E Mission Ave
Spokane Valley, WA 99216-1027 - Phone
- (509) 232-5766
- Fax
- (509) 321-5472
- NPI assigned
- Nov 6, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | CP00001820 | WA | Primary |
Addresses
Primary practice location
12715 E Mission Ave
Spokane Valley, WA 99216-1027
Mailing address
12715 E Mission Ave
Spokane Valley, WA 99216-1027
Phone (509) 232-5766
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2077844 | Medicaid | WA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CP00001820 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Behavioral Health Systems, Inc. | Past | Accepting new patients | |
| American Behavioral Health Systems, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Substance Abuse Rehabilitation Facility
- Chehalis, WA
- NPI 1598123226
-
- Substance Abuse Rehabilitation Facility
- Spokane Valley, WA
- NPI 1962991661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541462400000",
"number": "1972071199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12715 E MISSION AVE",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992161027",
"telephone_number": "509-232-5766",
"fax_number": "509-321-5472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12715 E MISSION AVE",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992161027",
"telephone_number": "509-232-5766",
"fax_number": "509-321-5472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "DOUGLAS",
"middle_name": "JOHN",
"credential": "CDP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-11-06",
"last_updated": "2018-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CP00001820",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2077844",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.