Provider Demographics
NPI:1497888986
Name:DEINES, WALTER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:
Last Name:DEINES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 BOEING DR
Mailing Address - Street 2:BLDG F, STE. 2
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-1047
Mailing Address - Country:US
Mailing Address - Phone:915-772-8210
Mailing Address - Fax:915-772-8991
Practice Address - Street 1:6501 BOEING DR
Practice Address - Street 2:BLDG. I, STE. 1-A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1096
Practice Address - Country:US
Practice Address - Phone:915-772-8210
Practice Address - Fax:915-772-8991
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical