Provider Demographics
NPI:1750477584
Name:WALSH, NORAH M (MSW LICSW)
Entity Type:Individual
Prefix:MS
First Name:NORAH
Middle Name:M
Last Name:WALSH
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 1ST ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201
Mailing Address - Country:US
Mailing Address - Phone:413-499-4138
Mailing Address - Fax:413-499-4138
Practice Address - Street 1:232 1ST ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:413-499-4138
Practice Address - Fax:413-499-4138
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1041701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1851764Medicaid
MAP02442OtherBLUE CROSS BLUE SHIELD
101457OtherMAGELLIN BEHAVIORAL HEALT
MAPZ2442Medicare ID - Type Unspecified