Active NPI
Michael R Walsh, PSYD, LP
- Clinical Psychologist
- Biloxi, MS
National Provider Identifier
1639194111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2010040768
- Practice address
- 301 Fisher St
Biloxi, MS 39534-2508 - Phone
- (228) 377-6550
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2010040768 | MO | Primary |
Addresses
Primary practice location
301 Fisher St
Biloxi, MS 39534-2508
Mailing address
301 Fisher St
Biloxi, MS 39534-2508
Phone (228) 377-6550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 490004794 | Medicaid | MO |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1639194111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 FISHER ST",
"city": "BILOXI",
"state": "MS",
"postal_code": "395342508",
"telephone_number": "228-377-6550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 FISHER ST",
"city": "BILOXI",
"state": "MS",
"postal_code": "395342508",
"telephone_number": "228-377-6550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "MICHAEL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PSYD, LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2010040768",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "490004794",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Biloxi, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.