William Michael Walsh Jr., LCPC-C

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

XL4302 Issued in ME

Practice address

77 Court St
Bangor, ME 04401-4723

Phone

(207) 941-0879

Fax

(207) 941-0880

NPI assigned

Apr 3, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Northern Lighthouse IncGroup PAC ID 2769611805, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Northern Lighthouse Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Mars Hill, ME
  • NPI 1831311968
  Medicare reassignment Care Compare group NPD
• Behavioral Health Center

  • Clinical Social Worker
  • Bangor, ME
  • NPI 1346333838
  NPD (past)
• Knada, PA

  dba Behavioral Health Center

  • Clinical Social Worker
  • Bangor, ME
  • NPI 1841795127
  NPD (past)

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1639597958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 COURT ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014723",
            "telephone_number": "207-941-0879",
            "fax_number": "207-941-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 COURT ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014723",
            "telephone_number": "207-941-0879",
            "fax_number": "207-941-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCPC-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-03",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "XL4302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dale C Walker, MD
• Brendan Wallace, MD
• Brian M Waller, DMD
• Dustin Waller, PHARMD
• Stephen M Walsh, MD
• David M Walter, M.D.
• Joy R Walters, LCPC-C
• Philip Alan Walton, CSW-IP
• Peter Yucheng Wang, DO
• Dane Wanniarachige, MD

• Professional Counselor in Bangor, ME
• Providers in Bangor, ME by specialty
• Professional Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.