Provider Demographics
NPI:1790234557
Name:WALKER, LINDSEY MARISSA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:MARISSA
Last Name:WALKER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3341 YOUREE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105
Mailing Address - Country:US
Mailing Address - Phone:318-219-4167
Mailing Address - Fax:318-219-4834
Practice Address - Street 1:3341 YOUREE DR STE 101
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2125
Practice Address - Country:US
Practice Address - Phone:318-219-4167
Practice Address - Fax:318-219-4834
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13531104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker