Provider Demographics
NPI:1508680117
Name:MULCAHY WALSH, KAREN JEANINE (LBA, BCBA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:JEANINE
Last Name:MULCAHY WALSH
Suffix:
Gender:F
Credentials:LBA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 VON HAGEN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-2126
Mailing Address - Country:US
Mailing Address - Phone:631-896-9125
Mailing Address - Fax:
Practice Address - Street 1:7 VON HAGEN AVE
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-2126
Practice Address - Country:US
Practice Address - Phone:631-896-9125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY71000154103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst