Individual provider Active NPI

Bonnie Jean Walker, L.I.S.W.

  • Clinical Social Worker
  • Mayfield Village, OH
National Provider Identifier
1487606836
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8663 Issued in OH
Practice address
6700 Beta Dr
Suite 301
Mayfield Village, OH 44143-2363
Phone
(440) 446-9696
Fax
(440) 449-1435
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8663 OH Primary

Addresses

Primary practice location

6700 Beta Dr
Suite 301
Mayfield Village, OH 44143-2363

Mailing address

6700 Beta Dr
Suite 301
Mayfield Village, OH 44143-2363
Phone (440) 446-9696

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

State licenses

LicenseStateTypeSpecialty
8663OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Marian E. Krieger, PH.D.,LLC CurrentSince May 16, 2016 Accepting new patients
Sharon Rose-Rego, PH.D., LLC Past Accepting new patients

Locations

6700 Beta Dr
Ste 112
Mayfield Village, OH 44143
Phone (440) 446-9696

Organizations & group practices 2

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1487606836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 BETA DR",
            "address_2": "SUITE 301",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441432363",
            "telephone_number": "440-446-9696",
            "fax_number": "440-449-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 BETA DR",
            "address_2": "SUITE 301",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441432363",
            "telephone_number": "440-446-9696",
            "fax_number": "440-449-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "BONNIE",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "L.I.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "8663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield Village, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.