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General NPI Number Information
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NPI Number | 1487163077
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Entity Type | Individual
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Provider Name | CANDICE WALKER LISW-S, LICDC
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Gender | Female
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 49 JOHNSON RD
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City | THE PLAINS
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State | OH
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Zip | 45780-1146
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Country | US
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Telephone | 740-853-0103
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Fax |
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Provider Business Mailing Address
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Address Line | 120 W MAIN ST
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City | CIRCLEVILLE
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State | OH
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Zip | 43113-1654
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2102921
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License Number State | OH
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