MEDICARE: MS. ANGIE M. 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
1	1041C0700X	Clinical Social Worker	1910C	AL
2	1041C0700X	Clinical Social Worker	1910 C	AL

General Provider Information

NPI Number	:	1689768103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGIE M. WALKER LCSW

Provider Business Mailing Address
First Line	:	234 CENTRAL HOSPITAL RD BLDG 329
Second Line	:
City	:	FT EISENHOWER
State	:	GA
Zip	:	30905-6003
Country	:	US
Telephone Number	:	706-787-2254
Fax Number	:

Provider Business Practice Location Address
First Line	:	234 CENTRAL HOSPITAL RD BLDG 329
Second Line	:
City	:	FT EISENHOWER
State	:	GA
Zip	:	30905-6003
Country	:	US
Telephone Number	:	706-787-2254
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	03/10/2024

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