Individual provider Active NPI

Denise Marie Walsh, MS, LBS, ICADC, MAC

  • Addiction (Substance Use Disorder) Counselor
  • Doylestown, PA
National Provider Identifier
1336615004
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
8788 Issued in PA
Practice address
400 Farm LN Ste a
Doylestown, PA 18901-4740
Phone
(215) 712-2582
NPI assigned
Oct 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 8788 PA Primary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X

Addresses

Primary practice location

400 Farm LN Ste a
Doylestown, PA 18901-4740

Mailing address

906 Monarch CT
Chalfont, PA 18914-2057
Phone (215) 712-2582

Other identifiers 2

IdentifierTypeStateIssuer
47-4621588MedicaidPA
8788MedicaidPA

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8788PAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1336615004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 MONARCH CT",
            "city": "CHALFONT",
            "state": "PA",
            "postal_code": "189142057",
            "telephone_number": "215-712-2582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FARM LN STE A",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189014740",
            "telephone_number": "215-712-2582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "DENISE",
        "middle_name": "MARIE",
        "credential": "MS, LBS, ICADC, MAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2021-02-16",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "8788",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47-4621588",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8788",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doylestown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.