MEDICARE: MR. JAMES J WALKER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	3519	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K018521	OTHER		MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538214093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES J WALKER LCSW

Provider Business Mailing Address
First Line	:	4502 TRUDY RURAL CT
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-1141
Country	:	US
Telephone Number	:	502-494-6631
Fax Number	:	502-333-9667

Provider Business Practice Location Address
First Line	:	155 LEES VALLEY RD
Second Line	:
City	:	SHEPHERDSVILLE
State	:	KY
Zip	:	40165-6143
Country	:	US
Telephone Number	:	502-494-6631
Fax Number	:	502-333-9667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	04/20/2021

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