Mary Ellen Walters, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS14566 Issued in CA

Practice address

8950 Villa la Jolla Dr Ste C112
La Jolla, CA 92037-1703

Phone

(858) 643-9771

Fax

(858) 455-7612

NPI assigned

Jan 6, 2006

Last updated

Jun 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary E Walters Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1588642805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 VILLA LA LOLLA DR.",
            "address_2": "STE. C112",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92037",
            "telephone_number": "858-643-9771",
            "fax_number": "858-455-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 VILLA LA JOLLA DR STE C112",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371703",
            "telephone_number": "858-643-9771",
            "fax_number": "858-455-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS14566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "WALTERS",
            "middle_name": "E",
            "credential": "L.C.S.W.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Amy Waller, RPH
• Christopher Lucas Walsh, M.D.
• Walter F. Merdinger, Inc.
• Joseph Franklin Walter, MD
• Gregory D. Walters, P.A.-C.
• Peter C. Walther, M.D.
• Thomas J Waltman, M.D.
• Amy Wang, MD
• Enoch J. Wang, M.D.
• Hohui Wang, M.D.

• Clinical Social Worker in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.