Dwight A Walls, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LSW0000004674 Issued in TN

Practice address

600 RB Wilson Dr
Huntingdon, TN 38344-1726

Phone

(731) 986-2213

Fax

(731) 986-0011

NPI assigned

Mar 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mental Health Centers & Clinics of Tennessee

  • Mental Health Counselor
  • Bolivar, TN
  • NPI 1255442794
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1235268798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 525",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "38344",
            "telephone_number": "731-986-2213",
            "fax_number": "731-986-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 RB WILSON DR",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383441726",
            "telephone_number": "731-986-2213",
            "fax_number": "731-986-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "DWIGHT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000004674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sri Siva Sai Sankalp Vadlapudi
• Wal-Mart Stores East LP
• Diana Crockett Walker, DPH
• Jeannie Walker, FNP
• Dwayne Walls, RN
• Tyler S Warbritton, PA-C
• Jessica Louise Warren, DPT
• William Ernest Webb, D.D.S.
• Susan Gamble Weingarten, RN
• West Tennessee Senior Eyecare PLLC

• Clinical Social Worker in Huntingdon, TN
• Providers in Huntingdon, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.