Provider Demographics
NPI:1396773677
Name:WALTON, JAMES ROBERT (LCSW)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:WALTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 W. 26 AVE.,
Mailing Address - Street 2:STE. 3000
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-3164
Mailing Address - Country:US
Mailing Address - Phone:806-331-2184
Mailing Address - Fax:806-331-4234
Practice Address - Street 1:3014 W 26TH AVE
Practice Address - Street 2:STE. 3000
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-3164
Practice Address - Country:US
Practice Address - Phone:806-331-2184
Practice Address - Fax:806-331-4234
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS121221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00S557Medicare ID - Type Unspecified