Basic Information
| Provider Information | |||||||||
| NPI: | 1023314127 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WALSH COUNSELING SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1113 RHODE ISLAND ST NE STE B | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871107839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052660441 | ||||||||
| FaxNumber: | 5052660504 | ||||||||
| Practice Location | |||||||||
| Address1: | 1113 RHODE ISLAND ST NE STE B | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871107839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052660441 | ||||||||
| FaxNumber: | 5052660504 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2011 | ||||||||
| LastUpdateDate: | 02/07/2011 | ||||||||
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| AuthorizedOfficialLastName: | BOX | ||||||||
| AuthorizedOfficialFirstName: | BRANDY | ||||||||
| AuthorizedOfficialMiddleName: | ALLISON | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5053632492 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LISW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | I-07102 | NM | Y | Agencies | Community/Behavioral Health |
No ID Information.