Lisa Kathleen Walsh, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301008820 Issued in MI

Practice address

233 Fulton St E
Suite 14
Grand Rapids, MI 49503-3200

Phone

(616) 915-2486

Fax

(616) 776-5543

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184371200000",
    "number": "1679651061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 FULTON ST E",
            "address_2": "SUITE 14",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033200",
            "telephone_number": "616-915-2486",
            "fax_number": "616-776-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 FULTON ST E",
            "address_2": "SUITE 14",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033200",
            "telephone_number": "616-915-2486",
            "fax_number": "616-776-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "LISA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301008820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jolene Faye Walma
• Krisin M Wals, LMSW
• Rebekah Wals
• David Walser
• Chenoah Walsh, NP
• Ralph T Walsh, DO
• Roberta J Walsh, RN.,CNP
• Karen Walstra, OTR
• Christina Walter, OTR/L
• Mary Walter, PA-C

• Clinical Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2007; 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.