Provider Demographics
NPI:1295923068
Name:WALSH, KATHERINE E (PHD, LICSW)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:E
Last Name:WALSH
Suffix:
Gender:F
Credentials:PHD, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:339 BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01062-1068
Mailing Address - Country:US
Mailing Address - Phone:413-687-4919
Mailing Address - Fax:413-748-3069
Practice Address - Street 1:19 CENTER CT
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3006
Practice Address - Country:US
Practice Address - Phone:413-748-3066
Practice Address - Fax:413-748-3069
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1044291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical