Active NPI
Vida L Weatherford Walsh, LPC,LCDC
- Mental Health Counselor
- Georgetown, TX
National Provider Identifier
1750639142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 65085
- Practice address
- 624 S Austin Ave
Suite 220
Georgetown, TX 78626-5707 - Phone
- (512) 966-4271
- NPI assigned
- Aug 16, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 11166 | TX | |
| Mental Health Counselor | 101YM0800X | 65085 | TX | Primary |
Addresses
Primary practice location
624 S Austin Ave
Suite 220
Georgetown, TX 78626-5707
Mailing address
624 S Austin Ave
Suite 220
Georgetown, TX 78626-5707
Phone (512) 966-4271
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65085 | TX | MD | Social Worker |
| 11166 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345075200000",
"number": "1750639142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "624 S AUSTIN AVE",
"address_2": "SUITE 220",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786265707",
"telephone_number": "512-966-4271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "624 S AUSTIN AVE",
"address_2": "SUITE 220",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786265707",
"telephone_number": "512-966-4271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEATHERFORD WALSH",
"first_name": "VIDA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "LPC,LCDC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-16",
"last_updated": "2012-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "11166",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "65085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.