Provider Demographics
NPI:1023664752
Name:WALSH, CARRIE LYNNE (LCSW)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNNE
Last Name:WALSH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 TWOMEY AVE
Mailing Address - Street 2:
Mailing Address - City:CALVERTON
Mailing Address - State:NY
Mailing Address - Zip Code:11933-1314
Mailing Address - Country:US
Mailing Address - Phone:774-239-0050
Mailing Address - Fax:
Practice Address - Street 1:184 TWOMEY AVE
Practice Address - Street 2:
Practice Address - City:CALVERTON
Practice Address - State:NY
Practice Address - Zip Code:11933-1314
Practice Address - Country:US
Practice Address - Phone:774-239-0050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical