Provider Demographics
NPI:1679505820
Name:WALKER, CHRISTINE ANNE (LICSW)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANNE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BLDG 4-2130 NORMANDY DRIVE
Mailing Address - Street 2:HHC, WARRIOR TRANSITION BATTALION
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28310
Mailing Address - Country:US
Mailing Address - Phone:910-643-1642
Mailing Address - Fax:
Practice Address - Street 1:BLDG 4-2130 NORMANDY DRIVE
Practice Address - Street 2:HHC, WARRIOR TRANSITION BATTALION
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28310
Practice Address - Country:US
Practice Address - Phone:910-643-1642
Practice Address - Fax:910-643-1642
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2013-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1811101YA0400X
TN6859104100000X
WVDP009427321041C0700X
OHS00144271041C0700X
DCLC500797901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker