Individual provider Active NPI

Edward D. Walsh, MSW, LMSW,CASAC/CADC

  • Social Worker
  • New York, NY
National Provider Identifier
1508003054
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
070757 Issued in NY
Practice address
330 W 58TH St Ste 508
New York, NY 10019-1819
Phone
(917) 862-0240
NPI assigned
Jan 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

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 8064 NY
Social Worker 104100000X 070757 NY Primary

Addresses

Primary practice location

330 W 58TH St Ste 508
New York, NY 10019-1819

Mailing address

330 W 58TH St Ste 508
New York, NY 10019-1819
Phone (917) 862-0240

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
8064NYMDAddiction (Substance Use Disorder) Counselor
070757NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232409600000",
    "number": "1508003054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST STE 508",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191819",
            "telephone_number": "917-862-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST STE 508",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191819",
            "telephone_number": "917-862-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "EDWARD",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "MSW, LMSW,CASAC/CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-20",
        "last_updated": "2009-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "8064",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "070757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; 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.