Provider Demographics
NPI:1871272799
Name:WALKER, DAVID LEE
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEE
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 W SUGAR CREEK RD STE 203
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-6102
Mailing Address - Country:US
Mailing Address - Phone:980-875-9473
Mailing Address - Fax:704-595-7155
Practice Address - Street 1:537 W SUGAR CREEK RD STE 203
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-6102
Practice Address - Country:US
Practice Address - Phone:980-875-9473
Practice Address - Fax:704-595-7155
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28594101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health