Provider Demographics
NPI:1841511235
Name:WALSH, LAURA L (PSYD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:L
Last Name:WALSH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:LINEBARGER
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:1417 S FAIRFAX ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3501
Mailing Address - Country:US
Mailing Address - Phone:773-474-0025
Mailing Address - Fax:
Practice Address - Street 1:1417 S FAIRFAX ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3501
Practice Address - Country:US
Practice Address - Phone:773-474-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-20
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0006327103TC0700X
KY129659103TC0700X
IL071009203103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical