Active NPI
Donald A Walters, LCSW
- Clinical Social Worker
- Racine, WI
National Provider Identifier
1417944216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 423-123
- Practice address
- 1244 Wisconsin Ave
Suite 303
Racine, WI 53403-1987 - Phone
- (262) 635-5520
- Fax
- (262) 635-5530
- NPI assigned
- Oct 5, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 423-123 | WI | Primary |
Addresses
Primary practice location
1244 Wisconsin Ave
Suite 303
Racine, WI 53403-1987
Mailing address
1244 Wisconsin Ave
Suite 303
Racine, WI 53403-1987
Phone (262) 635-5520
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39548600 | Medicaid | WI |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1417944216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1244 WISCONSIN AVE",
"address_2": "SUITE 303",
"city": "RACINE",
"state": "WI",
"postal_code": "534031987",
"telephone_number": "262-635-5520",
"fax_number": "262-635-5530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1244 WISCONSIN AVE",
"address_2": "SUITE 303",
"city": "RACINE",
"state": "WI",
"postal_code": "534031987",
"telephone_number": "262-635-5520",
"fax_number": "262-635-5530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "DONALD",
"middle_name": "A",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "423-123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39548600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.