Provider Demographics
NPI:1124303607
Name:WALKER, JANA MICHELLE (LSW)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:MICHELLE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 THORNTON RD
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:PA
Mailing Address - Zip Code:19373-1060
Mailing Address - Country:US
Mailing Address - Phone:201-892-4270
Mailing Address - Fax:
Practice Address - Street 1:601 UPLAND AVE
Practice Address - Street 2:STE #208 & 209
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19015-2434
Practice Address - Country:US
Practice Address - Phone:201-892-4270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW125177104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker