Individual
DR. GEORGE MCGWAINE WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LPC, NCC
Contact information
Practice address
78 MICHAEL RD APT D, NEW LONDON, CT 06320-2453
(561) 702-9788
Mailing address
78 MICHAEL RD APT D, NEW LONDON, CT 06320-2453
(561) 702-9788
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
002095
CT
101YP2500X
Professional Counselor
002095
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004121141
—
CT
01
—
201366
MHN
CT
01
—
321137/A324839
VALUE OPTIONS
CT
01
—
4553929
AETNA
CT
01
—
A412956
OXFORD
—
Enumeration date
04/10/2012
Last updated
07/29/2021
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