Healthcare Provider Details

I. General information

NPI: 1457779134
Provider Name (Legal Business Name): ERIN WALTON LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 05/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PICCARD DR
ROCKVILLE MD
20850-4320
US

IV. Provider business mailing address

1301 PICCARD DR
ROCKVILLE MD
20850-4320
US

V. Phone/Fax

Practice location:
  • Phone: 240-777-4000
  • Fax:
Mailing address:
  • Phone: 240-777-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16255
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: