Provider Demographics
NPI:1972335420
Name:WALSH, MICHELE A (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:A
Last Name:WALSH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 SPRING ST STE 303
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2080
Mailing Address - Country:US
Mailing Address - Phone:973-289-9496
Mailing Address - Fax:
Practice Address - Street 1:83 SPRING ST STE 303
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2080
Practice Address - Country:US
Practice Address - Phone:973-840-1850
Practice Address - Fax:973-383-0256
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC063706001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical