Healthcare Provider Details

I. General information

NPI: 1942512470
Provider Name (Legal Business Name): CHRISTOPHER WALSH MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2010
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 HAMMOCK PINE BLVD
CLEARWATER FL
33761-4226
US

IV. Provider business mailing address

905 HAMMOCK PINE BLVD
CLEARWATER FL
33761-4226
US

V. Phone/Fax

Practice location:
  • Phone: 617-359-0564
  • Fax:
Mailing address:
  • Phone: 617-359-0564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: