Provider Demographics
NPI:1750047254
Name:WALSHLENNON, EILISH (LPC)
Entity Type:Individual
Prefix:MS
First Name:EILISH
Middle Name:
Last Name:WALSHLENNON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 NETHERLAND AVE APT 2B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3423
Mailing Address - Country:US
Mailing Address - Phone:646-756-9067
Mailing Address - Fax:
Practice Address - Street 1:3215 NETHERLAND AVE APT 2B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3423
Practice Address - Country:US
Practice Address - Phone:646-756-9067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY880770101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool