| Colleen Walsh, Lpc, Llc | |
|
707 Whitlock Ave Sw Ste C28 Marietta GA 30064-4655 | |
| (404) 480-2038 | |
| Not Available |
| Full Name | Colleen Walsh, Lpc, Llc |
|---|---|
| Speciality | Counselor |
| Location | 707 Whitlock Ave Sw Ste C28, Marietta, Georgia |
| Authorized Official Name and Position | Colleen Walsh (OWNER, THERAPIST) |
| Authorized Official Contact | 7707152106 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colleen Walsh, Lpc, Llc 4480h S Cobb Dr Se # 258 Smyrna GA 30080-6958 Ph: (404) 480-2038 | Colleen Walsh, Lpc, Llc 707 Whitlock Ave Sw Ste C28 Marietta GA 30064-4655 Ph: (404) 480-2038 |
| NPI Number | 1992373120 |
|---|---|
| Provider Enumeration Date | 06/14/2021 |
| Last Update Date | 07/05/2024 |
| Certification Date | 07/05/2024 |
| Medicare PECOS PAC ID | 5597104695 |
|---|---|
| Medicare Enrollment ID | O20240423001482 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992373120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Colleen Elizabeth Walsh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245777952 PECOS PAC ID: 8628417623 Enrollment ID: I20240423002691 |
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