Provider Demographics
NPI:1306942230
Name:WALTON, JENNIFER LEE (LCSW, CASAC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEE
Last Name:WALTON
Suffix:
Gender:F
Credentials:LCSW, CASAC
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Mailing Address - Street 1:3345 BAKER RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1436
Mailing Address - Country:US
Mailing Address - Phone:716-862-8627
Mailing Address - Fax:716-862-8560
Practice Address - Street 1:3495 BAILEY AVE
Practice Address - Street 2:VA WESTERN NY HEALTHCARE SYSTEM SATP 10TH FLOOR
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1129
Practice Address - Country:US
Practice Address - Phone:716-862-8627
Practice Address - Fax:716-862-8560
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0730231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical