Individual provider Active NPI

Jennifer Ellen Walker, LISW-CP

  • Clinical Social Worker
  • Ladson, SC
National Provider Identifier
1942436084
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15887 Issued in SC
Practice address
3289 Pinewood Dr
Ladson, SC 29456-3829
Phone
(617) 970-3703
NPI assigned
Jun 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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 15887 SC Primary

Addresses

Primary practice location

3289 Pinewood Dr
Ladson, SC 29456-3829

Mailing address

3289 Pinewood Dr
Ladson, SC 29456-3829
Phone (617) 970-3703

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15887SCMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1942436084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3289 PINEWOOD DR",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294563829",
            "telephone_number": "617-970-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3289 PINEWOOD DR",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294563829",
            "telephone_number": "617-970-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JENNIFER",
        "middle_name": "ELLEN",
        "credential": "LISW-CP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "15887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.