Ted R Walker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3103116-3502 Issued in UT

Practice address

135 S Main St Ste 211
Heber City, UT 84032-2059

Phone

(435) 709-6698

NPI assigned

Apr 25, 2013

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1437593076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840320002",
            "telephone_number": "435-237-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S MAIN ST STE 211",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840322059",
            "telephone_number": "435-709-6698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2363 N Hill Field Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840416910",
            "country_code": "US",
            "telephone_number": "801-525-4645",
            "fax_number": "801-779-7808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "TED",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-25",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "3103116-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wasatch Back Wellness, PLLC
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• Clinical Social Worker in Heber City, UT
• Providers in Heber City, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.