Provider Demographics
NPI:1891239497
Name:WILLE WALSH, BARBARA (LCSW, CCM)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:WILLE WALSH
Suffix:
Gender:F
Credentials:LCSW, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 INDIAN HEAD RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-2919
Mailing Address - Country:US
Mailing Address - Phone:203-770-4207
Mailing Address - Fax:
Practice Address - Street 1:10 INDIAN HEAD RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-2919
Practice Address - Country:US
Practice Address - Phone:203-770-4207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0039061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical