Individual
MS. GLENDALE ELIZABETH WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC,CADC,CAC,CCDP
Contact information
Practice address
1600 STENTON AVE, PHILADELPHIA, PA 19141-2004
(215) 927-1196
Mailing address
1600 STENTON AVE, PHILADELPHIA, PA 19141-2004
(215) 927-1196
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC003797
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0041530
—
NJ
01
—
2045
ADDICTIOND COUNSELOR
PA
01
—
566
CERT.ADDICTION COUNSELOR
DE
01
—
6100
COOCURRING DISORDER PROFE
PA
01
—
9599
INTERNATIONAL. ADDICT. CO
PA
01
—
PC003797
LICENSE PROFESS. COUNSELO
PA
Enumeration date
03/28/2007
Last updated
07/09/2007
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