# MARYELLEN WALSH, LCSW LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518422559
- **Authorized official:** MARYELLEN WALSH LCSW (LICENSED CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (609) 703-6318

## Contact information

- **Practice address:** 138 E REVERE AVE, NORTHFIELD, NJ 08225-2438
- **Practice address phone:** (609) 703-6318
- **Mailing address:** 138 E REVERE AVE, NORTHFIELD, NJ 08225-2438
- **Mailing address phone:** (609) 703-6318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 02/04/2019
- **Last updated:** 02/04/2019