Provider Demographics
NPI:1700035706
Name:WALSH, KATY G (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATY
Middle Name:G
Last Name:WALSH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KATY
Other - Middle Name:
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:6384 MILL ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1404
Mailing Address - Country:US
Mailing Address - Phone:845-430-4809
Mailing Address - Fax:
Practice Address - Street 1:6384 MILL ST
Practice Address - Street 2:SUITE 2
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1404
Practice Address - Country:US
Practice Address - Phone:845-430-4809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017137103TA0400X, 103TC1900X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy