Individual
ANGELA WALTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
PO BOX 2671, GEARHART, OR 97138-2671
(435) 216-2170
Mailing address
PO BOX 2671, GEARHART, OR 97138-2671
(435) 216-2170
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
5656278-3501
UT
1041C0700X
Clinical Social Worker
6099
SD
1041C0700X
Clinical Social Worker
CSW.09927765
CO
1041C0700X
Clinical Social Worker
Primary
L6997
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20103
AZ LCSW
AZ
01
—
5656278-3501
STATE LICENSE
UT
01
—
6099
SD LCSW LICENSE
SD
01
—
BRAATA
SBHC STAFF CODE
UT
01
—
CSW.09927765
CO LCSW LICENSE
CO
01
—
L6997
OR LCSW LICENSE
OR
Enumeration date
05/24/2007
Last updated
12/10/2024
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