Healthcare Provider Details

I. General information

NPI: 1922234046
Provider Name (Legal Business Name): CAROL S. WALKER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2009
Last Update Date: 06/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

569 HIGHWAY 36
BELFORD NJ
07718-1651
US

IV. Provider business mailing address

569 HIGHWAY 36
BELFORD NJ
07718-1651
US

V. Phone/Fax

Practice location:
  • Phone: 732-495-2350
  • Fax: 732-495-2367
Mailing address:
  • Phone: 732-495-2350
  • Fax: 732-495-2367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SCO4400400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: