Provider Demographics
NPI:1801510581
Name:WALSH, RICHARD LEWIS (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEWIS
Last Name:WALSH
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 VINEYARDS BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-4748
Mailing Address - Country:US
Mailing Address - Phone:239-326-0796
Mailing Address - Fax:
Practice Address - Street 1:75 VINEYARDS BLVD STE 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-4748
Practice Address - Country:US
Practice Address - Phone:239-326-0796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW204761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical