Provider Demographics
NPI:1659335719
Name:WALKER, PAMELA J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:J
Last Name:WALKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 FALLBROOK ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18407-0514
Mailing Address - Country:US
Mailing Address - Phone:570-282-1732
Mailing Address - Fax:570-282-6529
Practice Address - Street 1:LAKE PLAZA 2 ROUTE 706 E
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:PA
Practice Address - Zip Code:18801-0285
Practice Address - Country:US
Practice Address - Phone:570-278-3393
Practice Address - Fax:570-278-1716
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW013253104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical