Provider Demographics
NPI:1073876470
Name:WALSH, COLLEEN HEALY (PSY D)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:HEALY
Last Name:WALSH
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LONGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-2831
Mailing Address - Country:US
Mailing Address - Phone:518-583-3191
Mailing Address - Fax:
Practice Address - Street 1:9 LONGWOOD DR
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2831
Practice Address - Country:US
Practice Address - Phone:518-583-3191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013510-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist