Provider Demographics
NPI:1043801053
Name:WALKER, SETH ADAM (LMSW)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:ADAM
Last Name:WALKER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 BROADWAY STE 510
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-8173
Mailing Address - Country:US
Mailing Address - Phone:914-214-9126
Mailing Address - Fax:
Practice Address - Street 1:1133 BROADWAY STE 510
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-8173
Practice Address - Country:US
Practice Address - Phone:914-214-9126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTMSW.005636104100000X
NY112532104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker