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General NPI Number Information
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NPI Number | 1629282991
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Entity Type | Individual
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Provider Name | LINDA WALTERS L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 07/22/2009
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Provider Practice Location Address
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Address Line | 4738 CORONADO DR
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City | CHARLOTTE
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State | NC
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Zip | 28212-4429
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Country | US
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Telephone | 704-553-9575
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Fax | 508-267-5906
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Provider Business Mailing Address
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Address Line | 707 TRAILHEAD LN
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City | FORT MILL
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State | SC
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Zip | 29708-8092
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Country | US
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Telephone | 704-553-9575
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Fax | 866-931-0818
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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 | C005623
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License Number State | NC
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