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NPI Code Detail

MEDICARE: JULIE ANNE WALTERS MS, LSW

MEDICARE:   JULIE ANNE WALTERS  MS, LSW
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
1104100000XSocial Worker150.109862IL

General Provider Information

NPI Number : 1588397673
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE ANNE WALTERS MS, LSW
Provider Business Mailing Address
First Line : 1836 VICTORIA LN
Second Line :
City : CHARLESTON
State : IL
Zip : 61920-2964
Country : US
Telephone Number : 217-508-8080
Fax Number : 217-512-2288
Provider Business Practice Location Address
First Line : 1836 VICTORIA LN
Second Line :
City : CHARLESTON
State : IL
Zip : 61920-2964
Country : US
Telephone Number : 217-508-8080
Fax Number : 217-512-2288
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2022
Last Update Date : 03/11/2026

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