=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225497696
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CLAUDINE M WALKER LCSW, LICSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/15/2016
-----------------------------------------------------
Last Update Date | 05/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 51340 HIGHWAY 97
-----------------------------------------------------
City | LA PINE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97739-9871
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-322-7500
-----------------------------------------------------
Fax | 541-322-7565
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2577 NE COURTNEY DR
-----------------------------------------------------
City | BEND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97701-7752
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-322-7500
-----------------------------------------------------
Fax | 541-322-7565
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 60558671
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | L16446
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------