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NPI Code Detail

MEDICARE: MS. SUZANNE PELLETIER-WALKER MSW, LISWS

MEDICARE: MS. SUZANNE PELLETIER-WALKER MSW, LISWS
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
1101YM0800XMental Health CounselorI.0010176-SUPVOH
21041C0700XClinical Social Worker0010176OH

General Provider Information

NPI Number : 1649711953
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUZANNE PELLETIER-WALKER MSW, LISWS
Provider Business Mailing Address
First Line : 2065 STONERIDGE DR
Second Line :
City : CIRCLEVILLE
State : OH
Zip : 43113-8956
Country : US
Telephone Number : 740-500-1391
Fax Number :
Provider Business Practice Location Address
First Line : 2065 STONERIDGE DR
Second Line :
City : CIRCLEVILLE
State : OH
Zip : 43113-8956
Country : US
Telephone Number : 740-500-1391
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2017
Last Update Date : 12/02/2025

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