Maryellen Walsh, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SC05205800 Issued in NJ

Practice address

2113 Wabash Ave
Linwood, NJ 08221-1443

Phone

(609) 703-6318

NPI assigned

Apr 26, 2012

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

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1710245808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2113 WABASH AVE",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211443",
            "telephone_number": "609-703-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2113 WABASH AVE",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211443",
            "telephone_number": "609-703-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "MARYELLEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SC05205800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jamie Fraser Walker, LMFT
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• Susan E. Ward, MSN, APN-C
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• Well BL Opco LLC (Brandywine Living at Brandall Estates LLC)

• Social Worker in Linwood, NJ
• Providers in Linwood, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.