Provider Demographics
NPI:1841359965
Name:WALKER, NOEL W (LISW)
Entity type:Individual
Prefix:MS
First Name:NOEL
Middle Name:W
Last Name:WALKER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3659 GREEN RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5727
Mailing Address - Country:US
Mailing Address - Phone:216-462-0543
Mailing Address - Fax:216-524-9823
Practice Address - Street 1:6505 ROCKSIDE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2342
Practice Address - Country:US
Practice Address - Phone:216-462-0543
Practice Address - Fax:216-524-9823
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00072411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW38361Medicare PIN