Individual provider Active NPI

Marissa Ann Walsh, LMHC

  • Mental Health Counselor
  • Providence, RI
National Provider Identifier
1043886294
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
530 N Main St
Providence, RI 02904-5762
Phone
(401) 276-4112
NPI assigned
May 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

530 N Main St
Providence, RI 02904-5762

Mailing address

530 N Main St
Providence, RI 02904-5762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240314003243 RI Practitioner - Mental Health Counselor 3577909332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Providence Center IncGroup PAC ID 9739080292, 42 clinicians

Practice addresses (Care Compare)

530 N Main St
Providence, RI 02904-5762
Phone (401) 274-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Providence Center Inc Counselor CurrentSince Jan 15, 2024 Accepting new patients
Affinity Physicians LLC. Current Accepting new patients
The Providence Center Past Accepting new patients

Locations

530 N Main St
Providence, RI 02904
Phone (401) 274-2500

528 N Main St
Providence, RI 02904
Phone (401) 276-4020

171 Service Ave
Warwick, RI 02886
Phone (401) 222-9157

Interoperability endpoints

  • Direct secure messaging: mgravel@direct.carene.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1043886294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045762",
            "telephone_number": "401-276-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "MARISSA",
        "middle_name": "ANN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.