Healthcare Provider Details

I. General information

NPI: 1679448971
Provider Name (Legal Business Name): JENNIFER WALKER, LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7133 NITTANY VALLEY DR
MILL HALL PA
17751-9013
US

IV. Provider business mailing address

109 W MAIN ST
LOCK HAVEN PA
17745-1219
US

V. Phone/Fax

Practice location:
  • Phone: 570-295-8116
  • Fax:
Mailing address:
  • Phone: 570-295-8399
  • Fax: 570-295-8399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JENNIFER JOY GLOVER-WALKER
Title or Position: OWNER
Credential: LCSW
Phone: 570-295-8399