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General NPI Number Information
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NPI Number | 1821585878
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Entity Type | Organization
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Legal Business Name | AILEEN WALSH LCSW PC
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Dates
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Enumeration Date | 04/16/2018
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Last Update Date | 07/03/2020
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Provider Practice Location Address
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Address Line | 109 SIMMONS DR N
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City | WOODSTOCK
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State | NY
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Zip | 12498-1249
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Country | US
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Telephone | 845-853-9090
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Fax |
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Provider Business Mailing Address
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Address Line | 56 STONY KILL RD
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City | ACCORD
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State | NY
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Zip | 12404-5443
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Country | US
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Telephone | 845-853-9090
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AILEEN WALSH
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Credential | LCSWR
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Telephone | 845-853-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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