Basic Information
| Provider Information | |||||||||
| NPI: | 1992895635 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARSH | ||||||||
| FirstName: | WALKER | ||||||||
| MiddleName: | ELTON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | PHD LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 85 WHISPERWOOD BLVD | ||||||||
| Address2: | SUITE 2C | ||||||||
| City: | SLIDELL | ||||||||
| State: | LA | ||||||||
| PostalCode: | 704581136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9856610560 | ||||||||
| FaxNumber: | 9857815395 | ||||||||
| Practice Location | |||||||||
| Address1: | 85 WHISPERWOOD BLVD | ||||||||
| Address2: | SUITE 2C | ||||||||
| City: | SLIDELL | ||||||||
| State: | LA | ||||||||
| PostalCode: | 704581136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9856610560 | ||||||||
| FaxNumber: | 9857815395 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | MFT-345 | LA | X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | MFT-345 | LA | X | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP1600X | LA | X | Behavioral Health & Social Service Providers | Counselor | Pastoral | 106H00000X | MFT-345 | LA | X | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.