1104051416 NPI number — ROBERT A. WALKER AND ASSOC, COUNSELING AND CONSULTING CENTER INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104051416 NPI number — ROBERT A. WALKER AND ASSOC, COUNSELING AND CONSULTING CENTER INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT A. WALKER AND ASSOC, COUNSELING AND CONSULTING CENTER INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104051416
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8722
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARWICK
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02888
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-383-2200
Provider Business Mailing Address Fax Number:
401-256-5209

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1087 WARWICK AVE REAR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARWICK
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02888
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-383-2200
Provider Business Practice Location Address Fax Number:
401-256-5209
Provider Enumeration Date:
05/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
WALKER
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
OWNER/CLINICIAN
Authorized Official Telephone Number:
401-383-2200

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MHC-00166 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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