Provider Demographics
NPI:1770215303
Name:WALKER, BONNIE ARLENE (LCSW, CTP, CMIP)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:ARLENE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LCSW, CTP, CMIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 BELMONT CIR SW
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32968-6714
Mailing Address - Country:US
Mailing Address - Phone:772-643-1101
Mailing Address - Fax:
Practice Address - Street 1:1750 BELMONT CIR SW
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32968-6714
Practice Address - Country:US
Practice Address - Phone:772-643-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC613320451041C0700X
FLSW233301041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical