Provider Demographics
NPI:1407522204
Name:WALSH, ADRIANA (LCMHCA, NCC)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:WALSH
Suffix:
Gender:F
Credentials:LCMHCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 ENVIRON WAY FL 4
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-4433
Mailing Address - Country:US
Mailing Address - Phone:919-636-5240
Mailing Address - Fax:
Practice Address - Street 1:1440 ENVIRON WAY FL 4
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-4433
Practice Address - Country:US
Practice Address - Phone:919-636-5240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16730101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor