Provider Demographics
NPI:1477025567
Name:SUSAN WALSHE, MFT, INC
Entity Type:Organization
Organization Name:SUSAN WALSHE, MFT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALSHE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:562-233-1223
Mailing Address - Street 1:4712 E 2ND ST # 736
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-5309
Mailing Address - Country:US
Mailing Address - Phone:562-480-2096
Mailing Address - Fax:562-567-0579
Practice Address - Street 1:6621 E PACIFIC COAST HWY STE 220
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-4239
Practice Address - Country:US
Practice Address - Phone:562-480-2096
Practice Address - Fax:562-567-0579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-30
Last Update Date:2018-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty