Organization Active NPI

Audra Walsh, PHD, LLC

  • Clinical Child & Adolescent Psychologist
  • St Petersburg, FL
National Provider Identifier
1073028734
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PY9148 Issued in FL
Legal business name
AUDRA WALSH, PHD, LLC
Practice address
1039 Park St N
St Petersburg, FL 33710-4317
Phone
(727) 599-3624
NPI assigned
Dec 4, 2017
Last updated
Oct 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Authorized official

Name
Dr. Audra Walsh, PHD
Title
Licensed Psychologist
Phone
(727) 599-3624

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PY9751 FL
Clinical Child & Adolescent Psychologist 103TC2200X PY9148 FL Primary

Addresses

Primary practice location

1039 Park St N
St Petersburg, FL 33710-4317

Mailing address

1039 Park St N
St Petersburg, FL 33710-4317
Phone (727) 599-3624

Other identifiers 2

IdentifierTypeStateIssuer
1477710416MedicaidFL
1205249752MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792022400000",
    "number": "1073028734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 PARK ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337104317",
            "telephone_number": "727-599-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 PARK ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337104317",
            "telephone_number": "727-599-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUDRA WALSH, PHD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "AUDRA",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "727-599-3624",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY9751",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY9148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477710416",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205249752",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.