Individual provider Active NPI

Cori L Walker, LCSW

  • Clinical Social Worker
  • Gulfport, MS
National Provider Identifier
1851808893
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C8438 Issued in MS
Practice address
3427 Washington Ave
Gulfport, MS 39507-3039
Phone
(888) 464-1811
Fax
(800) 416-3070
NPI assigned
Dec 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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 C8438 MS Primary

Addresses

Primary practice location

3427 Washington Ave
Gulfport, MS 39507-3039

Mailing address

3427 Washington Ave
Gulfport, MS 39507-3039
Phone (888) 464-1811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20190206002334 MS Practitioner - Clinical Social Worker 9234477852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3427 Washington Ave
Gulfport, MS 39507-3039
Phone (888) 464-1811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Resilience Psychotherapy, PLLC Mental Health CurrentSince Mar 1, 2019 Accepting new patients
Spark Counseling Center, LLC Mental Health PastSince Mar 1, 2019 Accepting new patients

Locations

1907 Pass Rd
Ste G
Biloxi, MS 39531
Phone (228) 222-2995

3427 Washington Ave
Gulfport, MS 39507
Phone (504) 300-9811

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": "1514505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1851808893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3427 WASHINGTON AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073039",
            "telephone_number": "888-464-1811",
            "fax_number": "800-416-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3427 WASHINGTON AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073039",
            "telephone_number": "888-464-1811",
            "fax_number": "800-416-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "CORI",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-29",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C8438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.