Provider Demographics
NPI:1588702070
Name:WALKER, AUDREY THAYER (MSS MSW LICSW)
Entity type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:THAYER
Last Name:WALKER
Suffix:
Gender:F
Credentials:MSS MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WASHINGTON CIRCLE NW
Mailing Address - Street 2:#406
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037
Mailing Address - Country:US
Mailing Address - Phone:202-331-1547
Mailing Address - Fax:202-333-0835
Practice Address - Street 1:3 WASHINGTON CIRCLE NW
Practice Address - Street 2:#406
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037
Practice Address - Country:US
Practice Address - Phone:202-331-1547
Practice Address - Fax:202-333-0835
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3003491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical