Provider Demographics
NPI:1710258025
Name:WALKER-THOMAS, COLETTE (MSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:COLETTE
Middle Name:
Last Name:WALKER-THOMAS
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7516 ROXY DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2063
Mailing Address - Country:US
Mailing Address - Phone:443-392-4095
Mailing Address - Fax:410-655-4243
Practice Address - Street 1:7516 ROXY DR
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2063
Practice Address - Country:US
Practice Address - Phone:443-392-4095
Practice Address - Fax:410-655-4243
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD098891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical