Monique McWilliams Wall, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

30922 Issued in TX

Practice address

110 W ENT Ave
Attn: 21 Mdos/Sgoh-Mental Health
Peterson AFB, CO 80914-1595

Phone

(719) 556-8943

Fax

(719) 556-7399

NPI assigned

Feb 17, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1203206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1649448275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST BLDG 959",
            "city": "PETERSON AFB",
            "state": "CO",
            "postal_code": "809141541",
            "telephone_number": "719-556-8943",
            "fax_number": "719-556-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W ENT AVE",
            "address_2": "ATTN: 21 MDOS/SGOH-MENTAL HEALTH",
            "city": "PETERSON AFB",
            "state": "CO",
            "postal_code": "809141595",
            "telephone_number": "719-556-8943",
            "fax_number": "719-556-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "MONIQUE",
        "middle_name": "MCWILLIAMS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-17",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "1773-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "30922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Joseph Tucholski Jr., DDS
• Jeffrey A Turner, DPT
• Francesca Vasta-Falldorf, DDS
• Kim Lee Vehige, LCSW
• George Allen Waddell Jr., M.D.
• Travis Paul Waters, PA-C
• John Franklin Watkins III, DENTIST DDS
• Irene Ai-Ling Wiles, PH.D.
• Jefferie Michael Wilson, MD
• June Yi, NP-C

• Clinical Social Worker in Peterson AFB, CO
• Providers in Peterson AFB, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.