Healthcare Provider Details

I. General information

NPI: 1023314127
Provider Name (Legal Business Name): WALSH COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2011
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 LOUISIANA BLVD NE STE 4200
ALBUQUERQUE NM
87110-5433
US

IV. Provider business mailing address

2155 LOUISIANA BLVD NE STE 4200
ALBUQUERQUE NM
87110-5433
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberI-07102
License Number StateNM

VIII. Authorized Official

Name: MS. PETER WALSH
Title or Position: CLINICAL DIRECTOR
Credential: LISW
Phone: 505-363-2492