Individual provider Active NPI

Kathleen Walsh, LPC

  • Professional Counselor
  • Du Bois, PA
National Provider Identifier
1326174871
Registry record updated Feb 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC001131 Issued in PA
Practice address
635 Maple Ave
Du Bois, PA 15801-2376
Phone
(814) 375-6379
Fax
(814) 375-9320
NPI assigned
Feb 26, 2007
Last updated
Feb 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC001131 PA Primary

Addresses

Primary practice location

635 Maple Ave
Du Bois, PA 15801-2376

Mailing address

5105 Monroe Rd
Suite B
Charlotte, NC 28205-7825
Phone (704) 910-2313

Other identifiers 1

IdentifierTypeStateIssuer
6104200MedicaidNC

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
PC001131PAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517961600000",
    "number": "1326174871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 MONROE RD",
            "address_2": "SUITE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057825",
            "telephone_number": "704-910-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 MAPLE AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012376",
            "telephone_number": "814-375-6379",
            "fax_number": "814-375-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2018-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC001131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104200",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; 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.