Provider Demographics
NPI:1942405139
Name:WALKER, JANET LOUISE (LISW)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LOUISE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:LOUISE
Other - Last Name:SHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:210 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-1898
Mailing Address - Country:US
Mailing Address - Phone:641-236-2347
Mailing Address - Fax:641-236-2586
Practice Address - Street 1:210 4TH AVE
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-1898
Practice Address - Country:US
Practice Address - Phone:641-236-2347
Practice Address - Fax:641-236-2586
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03347104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAAPPLIED FORMedicare UPIN
IAI20395Medicare PIN