Provider Demographics
NPI:1316564800
Name:WALSH, MEGAN MARIE (BA, CADC)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:MARIE
Last Name:WALSH
Suffix:
Gender:F
Credentials:BA, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9408 DOUBLE R BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4800
Mailing Address - Country:US
Mailing Address - Phone:775-964-4898
Mailing Address - Fax:866-356-7299
Practice Address - Street 1:9498 DOUBLE R BLVD STE A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-2905
Practice Address - Country:US
Practice Address - Phone:775-964-4898
Practice Address - Fax:866-356-7299
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV07417-C101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV07417-COtherBOARD OF EXAMINERS FOR ALCOHOL, DRUG AND PROBLEM GAMBLING COUNSELORS