MEDICARE: MS. LUCIA MARIE WALSH

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
1	103T00000X	Psychologist	PSY.0005377	CO
2	101YM0800X	Mental Health Counselor
3	103T00000X	Psychologist	APIT18468	IN

General Provider Information

NPI Number	:	1689235210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LUCIA MARIE WALSH

Provider Business Mailing Address
First Line	:	723 DELAWARE ST FL 3
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-4504
Country	:	US
Telephone Number	:	303-602-1899
Fax Number	:

Provider Business Practice Location Address
First Line	:	723 DELAWARE ST FL 3
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-4504
Country	:	US
Telephone Number	:	303-602-1899
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2019
Last Update Date	:	12/08/2025

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