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General NPI Number Information
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NPI Number | 1326447996
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Entity Type | Individual
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Provider Name | CORYLL WALSH LPCC
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Gender | Female
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 05/14/2023
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Provider Practice Location Address
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Address Line | 1241 CARLSBAD VILLAGE DR # 209
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City | CARLSBAD
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State | CA
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Zip | 92008-1960
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Country | US
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Telephone | 858-432-3778
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Fax |
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Provider Business Mailing Address
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Address Line | 4921 ROJA DR
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City | OCEANSIDE
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State | CA
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Zip | 92057-4321
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Country | US
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Telephone | 619-634-4703
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPCC13793
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License Number State | CA
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