Provider Demographics
NPI:1043526486
Name:WALKER, MARCIA ALEXIS (LISW)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:ALEXIS
Last Name:WALKER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6490 FIRETHORN AVE
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-1046
Mailing Address - Country:US
Mailing Address - Phone:614-516-6244
Mailing Address - Fax:
Practice Address - Street 1:950 TAYLOR STATION RD
Practice Address - Street 2:SUITE Q
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-6670
Practice Address - Country:US
Practice Address - Phone:614-516-6244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 09000571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical