Individual provider Active NPI

Julie Walls, LCSW

  • Clinical Social Worker
  • Newport News, VA
National Provider Identifier
1063624575
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904001228 Issued in VA
Practice address
732 Thimble Shoals Blvd. Suite 702
Newport News, VA 23606-2612
Phone
(757) 761-4755
Fax
(757) 873-4915
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904001228 VA Primary

Addresses

Primary practice location

732 Thimble Shoals Blvd. Suite 702
Newport News, VA 23606-2612

Mailing address

732 Thimble Shoals Blvd. Suite 702
Newport News, VA 23606-2612
Phone (757) 761-4755

Other identifiers 1

IdentifierTypeStateIssuer
8907277MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904001228VAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063624575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 THIMBLE SHOALS BLVD. SUITE 702",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062612",
            "telephone_number": "757-761-4755",
            "fax_number": "757-873-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 THIMBLE SHOALS BLVD. SUITE 702",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062612",
            "telephone_number": "757-761-4755",
            "fax_number": "757-873-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "JULIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904001228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8907277",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.