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NPI Code Detail

MEDICARE: MS. KAREN ANN WALSH LCSW-R

MEDICARE: MS. KAREN ANN WALSH LCSW-R
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker050752-1NY

General Provider Information

NPI Number : 1134221047
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAREN ANN WALSH LCSW-R
Provider Business Mailing Address
First Line : 6586 CAYUGA RD
Second Line :
City : CAYUGA
State : NY
Zip : 13034-3174
Country : US
Telephone Number : 315-252-0568
Fax Number :
Provider Business Practice Location Address
First Line : 146 NORTH ST
Second Line :
City : AUBURN
State : NY
Zip : 13021-1831
Country : US
Telephone Number : 315-253-2746
Fax Number : 315-253-1077
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2006
Last Update Date : 01/09/2014

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