Organization
WALKER THERAPY LLC
Active
Other names
Flourish Mental Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IAN D WALKER MS, LPC, BC-TMH (MEMBER)
(601) 914-4492
Entity
Organization
Contact information
Practice address
1640 LELIA DR STE 120, JACKSON, MS 39216-4873
(601) 914-4492
(601) 914-6715
Mailing address
1640 LELIA DR STE 120, JACKSON, MS 39216-4873
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06285286
—
MS
Enumeration date
04/05/2022
Last updated
08/17/2022
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