Provider Demographics
NPI:1386754182
Name:WALKER, KITTY (LCSW)
Entity type:Individual
Prefix:
First Name:KITTY
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9105 TEXAS SUN DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-6354
Mailing Address - Country:US
Mailing Address - Phone:512-280-5427
Mailing Address - Fax:512-280-5485
Practice Address - Street 1:5511 PARKCREST DR STE 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4937
Practice Address - Country:US
Practice Address - Phone:512-452-4464
Practice Address - Fax:512-280-5495
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00S67NMedicare ID - Type UnspecifiedMEDICARE, BCBS