Walter James Healey, M.D.

Individual provider Active NPI Psychiatry Physician · Provincetown, MA

NPI 1477528628 · NPPES record last updated Jan 12, 2011

Key facts

NPI
1477528628
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
150216 (MA)
Practice address
30 Conwell St
Gosnold Thorne Counseling
Provincetown, MA 02657-1548
Phone
(508) 487-2449
Fax
(508) 487-1921
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
150216MAMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Common Ground Counseling & Personal Growth Center, LLC Past Accepting new patients
Gosnold, Inc. Past
since Mar 22, 1996
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 150216 MA Yes
Geriatric Psychiatry Physician 2084P0805X 150216 MA

Addresses

Primary practice location

30 Conwell St
Gosnold Thorne Counseling
Provincetown, MA 02657-1548

Mailing address

43 Race Point Road
Unit B, Gosnold-Thorne Counseling
Provincetown, MA 02657
Phone (508) 487-2449

Other identifiers

IdentifierTypeStateIssuer
5293582OtherMAAETNA
150216OtherMATUFTS
15512200OtherMAMAGELLAN
3165540MedicaidMA
J18180OtherMABLUE CROSS
260037303OtherMAUNITED HEALTHCARE
4383-01OtherMAPACIFICARE

Other providers in Provincetown, MA

All providers in Provincetown, MA · Psychiatry Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.