Healthcare Provider Details

I. General information

NPI: 1104398114
Provider Name (Legal Business Name): WALSH COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2019
Last Update Date: 01/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 INDIAN SCHOOL RD NE STE A
ALBUQUERQUE NM
87110-4504
US

IV. Provider business mailing address

7301 INDIAN SCHOOL RD NE STE A
ALBUQUERQUE NM
87110-4504
US

V. Phone/Fax

Practice location:
  • Phone: 505-508-3563
  • Fax: 505-508-3564
Mailing address:
  • Phone: 505-266-0441
  • Fax: 505-266-0504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JULIE E WALSH
Title or Position: OWNER
Credential:
Phone: 505-266-0441