Provider Demographics
NPI:1487778247
Name:SELF REALIZATION CONSULTING, INC.
Entity type:Organization
Organization Name:SELF REALIZATION CONSULTING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:EDD
Authorized Official - Phone:302-312-8221
Mailing Address - Street 1:507 LILAC DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-8639
Mailing Address - Country:US
Mailing Address - Phone:302-312-8221
Mailing Address - Fax:302-378-9128
Practice Address - Street 1:507 LILAC DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-8639
Practice Address - Country:US
Practice Address - Phone:302-312-8221
Practice Address - Fax:302-378-9128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000757103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty