Individual provider Active NPI

Dennis Walker, LICSW

  • Clinical Social Worker
  • Portsmouth, NH
National Provider Identifier
1174569115
Registry record updated Aug 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1654 Issued in NH
Practice address
1145 Sagamore Ave
Portsmouth, NH 03801-5503
Phone
(603) 431-6703
Fax
(603) 430-3753
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1654 NH Primary
Clinical Social Worker 1041C0700X 1025795 MA

Addresses

Primary practice location

1145 Sagamore Ave
Portsmouth, NH 03801-5503

Mailing address

1145 Sagamore Ave
Portsmouth, NH 03801-5503
Phone (603) 431-6703

Other identifiers 1

IdentifierTypeStateIssuer
3078870MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050810000119 MA Practitioner - Clinical Social Worker 0244269298 Reassigns benefits to 1 organization
I20171017000310 NH Practitioner - Clinical Social Worker 0244269298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Seacoast Mental Health Center IncGroup PAC ID 0749240208, 45 clinicians

Practice addresses (Care Compare)

1145 Sagamore Ave
Portsmouth, NH 03801-5503
Phone (603) 431-6703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1025795MAMDClinical Social Worker
1654NHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Seacoast Mental Health Center, Inc. CurrentSince Jul 20, 2017 Accepting new patients
Psychotherapy Associates of North Reading Clinical CurrentSince May 25, 2011 Accepting new patients
Wilmington Family Counseling Service Inc PastSince Nov 1, 1996 Accepting new patients

Locations

5 Market Sq
Ste 102
Amesbury, MA 01913
Phone (978) 664-2556

58 Concord St
North Reading, MA 01864
Phone (866) 331-3345

1145 Sagamore Ave
Portsmouth, NH 03801
Phone (603) 431-6703

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376611200000",
    "number": "1174569115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 SAGAMORE AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038015503",
            "telephone_number": "603-431-6703",
            "fax_number": "603-430-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 SAGAMORE AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038015503",
            "telephone_number": "603-431-6703",
            "fax_number": "603-430-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2013-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1654",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1025795",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3078870",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.