Provider Demographics
NPI:1164162210
Name:WALKER, LOTTIE MICHELLE (MSW, MST)
Entity Type:Individual
Prefix:
First Name:LOTTIE
Middle Name:MICHELLE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MSW, MST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 ADAMS ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1126
Mailing Address - Country:US
Mailing Address - Phone:202-288-7572
Mailing Address - Fax:
Practice Address - Street 1:5039 CONNECTICUT AVE NW STE 5
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2056
Practice Address - Country:US
Practice Address - Phone:202-237-1196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLMSW260331041C0700X
DCLG500829101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical