AUDRA WALSH, PHD, LLC (NPI# 1073028734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073028734 |
| Entity Type | Organization |
| Organization Name | AUDRA WALSH, PHD, LLC |
| Practice Address |
1039 Park St N St Petersburg FL 33710-4317 |
| Practice Telephone | 7275993624 |
| Mailing Telephone | 7275993624 |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2017-12-04 |
| Authorized Official Name | DR. AUDRA WALSH (LICENSED PSYCHOLOGIST) |
| Authorized Official Telephone | 7275993624 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PY9751 | FL | Behavioral Health & Social Service Providers |
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PY9148 | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 1477710416 | 05 | |
| FL | 1205249752 | 05 |
| Street Address |
1039 PARK ST N |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33710-4317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615812 | Bay Vision Inc | Optometrist | 6951 22nd Ave North, St. Petersburg, FL 33710 | 2020-10-05 |
| 1821566845 | Harish J. Patel, Md | Non-Pharmacy Dispensing Site | 6449 38th Avenue North, Suite B3, Saint Petersburg, FL 33710 | 2018-11-07 |
| 1659860708 | Lydia M Gomez | Physical Therapist | 6775 Crosswinds Dr. N, Saint Petersburg, FL 33710 | 2018-05-04 |
| 1619498169 | Tiffiny C Rudkin | Massage Therapist | 3039 - 49th St. N., St. Petersburg, FL 33710 | 2017-07-05 |
| 1114456480 | Roberto Macedo Dentistry LLC | Dentist | 7801 38th Ave North, St. Petersburg, FL 33710 | 2017-06-08 |
| 1528429495 | Frank Michael Massotto Jr. | Nurse Practitioner | 3251 66th St. North, St Petersburg, FL 33710 | 2016-03-18 |
| 1235522889 | Toby Weinman Assisted Living Residence | Assisted Living Facility | 240 59th St N, St Petersburg, FL 33710 | 2015-03-06 |
| 1821415951 | Ryan Troup | Physician Assistant | 603 - 7th St. S, Suite 360, Emergency Physicians of Saint Petersburg, Saint Petersburg, FL 33710 | 2014-03-26 |
| 1629491600 | Garett Janes Sears | Psychologist | 1913 Tyrone Blvd, St. Petersburg, FL 33710 | 2014-01-28 |
| 1912331943 | Solimar Jimenez Diaz | Obstetrics & Gynecology | 6450 38th Ave N Ste 200, St Petersburg, FL 33710 | 2013-08-27 |
| Find all providers in zip 33710 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265699896 | Michael Frederick Cohen | Psychologist | 535 Central Ave Ste 300, St Petersburg, FL 33701-3703 | 2008-05-21 |
| 1326600107 | Sarah Stromberg | Psychologist | 880 6th St S, St Petersburg, FL 33701-4827 | 2019-07-02 |
| 1043662372 | William Frye | Psychologist | 880 6th St S Ste 430, St Petersburg, FL 33701-4825 | 2016-07-11 |
| 1669605861 | Aja Michelle Meyer | Psychologist | 880 6th St S, Suite 110, St Petersburg, FL 33701-4827 | 2009-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376142463 | Krecer Psychological Services, LLC | Psychologist | 2015 Meadow Pond Way, Orlando, FL 32824-5060 | 2020-10-20 |
| 1912525866 | Vicky Wolfe | Psychologist | 203 Hollywood Blvd Ne, Fort Walton Beach, FL 32548-5775 | 2020-07-08 |
| 1144841727 | Chalfin Psychology Services, Inc. | Psychologist | 7800 Sw 57th Ave Ste 114, South Miami, FL 33143-5543 | 2020-05-05 |
| 1346738705 | Tampa Psychology Group | Psychologist | 1463 Oakfield Dr Ste 109, Brandon, FL 33511 | 2018-05-01 |
| 1447765631 | Cristina Anderson | Psychologist | 3081 Salzedo St Ste 202, Coral Gables, FL 33134-6725 | 2017-12-10 |
| 1801327564 | Paola Granados-radlick | Psychologist | 1200 Brickell Ave Ste 850, Miami, FL 33131-3212 | 2017-03-24 |
| 1205388527 | Safe Landing, Inc | Psychologist | 9200 Nw 8th Ave, Miami, FL 33150-2016 | 2016-11-03 |
| 1124574595 | Michelle C Fernandez | Psychologist | 7800 Sw 57th Avenue Suite 114, South Miami, FL 33143 | 2016-08-26 |
| 1952764060 | Penelope L. Norton, Phd | Psychologist | 555 W Granada Blvd Ste E3, Ormond Beach, FL 32174-9401 | 2016-04-05 |
| 1033574686 | Erika Tornatore | Psychologist | 1485 S Semoran Blvd., Suite 1448, Winter Park, FL 32792 | 2015-12-28 |
| Find all providers with the same taxonomy | ||||
| City | ST PETERSBURG |
| Zip Code | 33710 |
Please comment or provide details below to improve the information on AUDRA WALSH, PHD, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.