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General NPI Number Information
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NPI Number | 1922028737
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Entity Type | Individual
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Provider Name | MISTY LYNN WALTER LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 57 DORA LANE
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City | GREENUP
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State | KY
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Zip | 41144
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Country | US
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Telephone | 606-473-7333
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Fax | 606-473-7335
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Provider Business Mailing Address
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Address Line | 900 BEASLEY ST
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City | LEXINGTON
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State | KY
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Zip | 40509-4266
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Country | US
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Telephone | 859-254-1035
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Fax | 859-254-2075
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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 | 1258
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License Number State | KY
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