Organization
WALCK PRACTICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN WALCK LCSW-R (PRESIDENT)
(716) 531-8433
Entity
Organization
Contact information
Practice address
405 BEWLEY BUILDING, LOCKPORT, NY 14094-2934
(716) 531-8433
Mailing address
5104 CARRIAGE LN, LOCKPORT, NY 14094-9747
(716) 531-8433
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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