=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780470591
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WALK IN PROGRESS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2025
-----------------------------------------------------
Last Update Date | 04/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 705 KINDERKAMACK RD
-----------------------------------------------------
City | RIVER EDGE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07661-2439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-983-2631
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 656
-----------------------------------------------------
City | ORADELL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07649-0656
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-983-2631
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOCIAL WORKER
-----------------------------------------------------
Name | AMANDA L WALKER
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 201-983-2631
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------