Provider Demographics
NPI:1003070806
Name:WALTERS, DENISE AG (LCSW)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:AG
Last Name:WALTERS
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 1:55 GARDEN ST APT 5
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-2451
Mailing Address - Country:US
Mailing Address - Phone:845-454-0892
Mailing Address - Fax:845-454-0892
Practice Address - Street 1:115 DELAFIELD ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1749
Practice Address - Country:US
Practice Address - Phone:845-790-6033
Practice Address - Fax:845-337-3678
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0978761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical