Provider Demographics
NPI:1285985788
Name:WALTON, NORMA NICHOLE (LCSW, CSAC)
Entity type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:NICHOLE
Last Name:WALTON
Suffix:
Gender:F
Credentials:LCSW, CSAC
Other - Prefix:
Other - First Name:NORMA
Other - Middle Name:NICHOLE
Other - Last Name:MCINTYRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER
Mailing Address - Street 2:CMR 402 APO AE
Mailing Address - City:APO AE
Mailing Address - State:GERMANY
Mailing Address - Zip Code:09180
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER
Practice Address - Street 2:CMR 402 APO AE
Practice Address - City:APO AE
Practice Address - State:GERMANY
Practice Address - Zip Code:09180
Practice Address - Country:DE
Practice Address - Phone:49637-186-8590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040076501041C0700X
NCC0075701041C0700X
DCLC500793431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical