Provider Demographics
NPI:1235552563
Name:WALK, CAITLIN R (MSW,LCSW)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:R
Last Name:WALK
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-2716
Mailing Address - Country:US
Mailing Address - Phone:970-699-5277
Mailing Address - Fax:
Practice Address - Street 1:410 9TH ST
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-4028
Practice Address - Country:US
Practice Address - Phone:412-664-7146
Practice Address - Fax:412-664-1884
Is Sole Proprietor?:No
Enumeration Date:2014-01-22
Last Update Date:2017-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW130989104100000X
COCSW.099251121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker