Jonathan Edward Walker, L.C.S.W.
Individual provider Active NPI Clinical Social Worker · Thomasville, GA
NPI 1306116157 · NPPES record last updated Mar 2, 2020
Key facts
- NPI
- 1306116157
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- CSW007043 (GA)
- Practice address
- 1102 Smith Ave
Thomasville, GA 31792-5739 - Phone
- (229) 225-5208
- NPI assigned
- Jan 11, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW007043 | GA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW007043 | GA | Yes |
Addresses
Primary practice location
1102 Smith Ave
Thomasville, GA 31792-5739
Mailing address
1102 Smith Ave
Thomasville, GA 31792-5739
Phone (229) 225-5208
NPI Registry JSON
{
"created_epoch": "1326240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583107200000",
"number": "1306116157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1102 SMITH AVE",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317925739",
"telephone_number": "229-225-5208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 SMITH AVE",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317925739",
"telephone_number": "229-225-5208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "JONATHAN",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "L.C.S.W.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-11",
"last_updated": "2020-03-02",
"certification_date": "2020-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW007043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thomasville, GA
- Barbara Walden
- Holly Waldrep
- Heather H. Waldrop
- Walgreen Co
- Walgreen Co
- Alan S Waller
- Bradley N Walter
- Jaleishia Walton
- Jordan Maxwell Ward
- Martha S. Ward
All providers in Thomasville, GA · Clinical Social Worker in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.