Provider Demographics
NPI:1437298114
Name:WALKER, PETER BENJAMIN (MSW LCSW)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:BENJAMIN
Last Name:WALKER
Suffix:
Gender:M
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 1:10950 SCHUETZ RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146
Mailing Address - Country:US
Mailing Address - Phone:314-812-9326
Mailing Address - Fax:314-812-9398
Practice Address - Street 1:10950 SCHUETZ RD
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146
Practice Address - Country:US
Practice Address - Phone:314-812-9326
Practice Address - Fax:314-812-9398
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0030971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical