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NPI Code Detail

MEDICARE: MR. CHARLES B WALKER LCSW

MEDICARE:  MR. CHARLES B WALKER  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorACSW 66649CA
2101YM0800XMental Health Counselor94717
31041C0700XClinical Social Worker94717CA

General Provider Information

NPI Number : 1265780662
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHARLES B WALKER LCSW
Provider Business Mailing Address
First Line : 1327 E CRANE CT
Second Line :
City : COMPTON
State : CA
Zip : 90221-4931
Country : US
Telephone Number : 310-997-5496
Fax Number :
Provider Business Practice Location Address
First Line : 8929 S SEPULVEDA BLVD STE 404
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-3634
Country : US
Telephone Number : 310-997-5396
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2012
Last Update Date : 02/10/2022

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Directions to “ MR. CHARLES B WALKER LCSW” Practice Location

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