Provider Demographics
NPI:1851074306
Name:WALK AND TALK WITH DORI
Entity Type:Organization
Organization Name:WALK AND TALK WITH DORI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DORI
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-621-3497
Mailing Address - Street 1:432 THRESHER ST
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-1507
Mailing Address - Country:US
Mailing Address - Phone:815-621-3497
Mailing Address - Fax:
Practice Address - Street 1:432 THRESHER ST
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-1507
Practice Address - Country:US
Practice Address - Phone:815-797-2382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty