Timothy Brian Walsh, LP
Individual provider Active NPI Psychologist · Centerville, MN
NPI 1124376702 · NPPES record last updated Aug 29, 2012
Key facts
- NPI
- 1124376702
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- Practice address
- 7041 20TH Ave
Centerville, MN 55038-9737 - Phone
- (651) 407-3631
- Fax
- (651) 407-3751
- NPI assigned
- Aug 29, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Innovations, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | MN | Yes |
Addresses
Primary practice location
7041 20TH Ave
Centerville, MN 55038-9737
Mailing address
7041 20TH Ave
Centerville, MN 55038-9737
Phone (651) 407-3631
Other providers in Centerville, MN
All providers in Centerville, MN · Psychologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.