Individual provider Active NPI

Daniel Augustine Walsh III, LCAT

  • Art Therapist
  • Brooklyn, NY
National Provider Identifier
1154945590
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Art TherapistTaxonomy code 221700000X
License
002311 Issued in NY
Practice address
451 Clarkson Ave
Brooklyn, NY 11203-2054
Phone
(718) 781-8659
NPI assigned
Jun 1, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Art Therapist 221700000X 002311 NY Primary

Addresses

Primary practice location

451 Clarkson Ave
Brooklyn, NY 11203-2054

Mailing address

533 Van Siclen Ave
Brooklyn, NY 11207-5616
Phone (718) 781-8659

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Epic Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
002311NYMDArt Therapist

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1154945590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 VAN SICLEN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112075616",
            "telephone_number": "718-781-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032054",
            "telephone_number": "718-781-8659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "DANIEL",
        "middle_name": "AUGUSTINE",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-01",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "002311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Epic",
            "affiliation": "N",
            "endpointDescription": "Intranet used within clinical setting.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Client/patient medical history.",
            "address_1": "451 Clarkson Ave",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112032054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.