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Provider Information for 1861069510


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STACY WALSH LCSW


Sex: Female

NPI: 1861069510
Last Updated: 2021-06-09
Certification Date: 2021-06-09

Details

NameValue
NPI1861069510
Enumeration Date2021-06-09
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 2620 OLIVE ST
DENVER, CO 80207-2917
United States

Phone: 772-284-2686 | Fax:
 
Primary Practice Address 2620 OLIVE ST
DENVER, CO 80207-2917
United States

Phone: 772-284-2686 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 104100000X - Social Worker COCSW.09924448