Individual
CHARLES R WALSH JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
9228 GEORGE WASHINGTON MEMORIAL HWY, GLOUCESTER, VA 23061-4162
(804) 693-5068
(804) 639-7407
Mailing address
9228 GEORGE WASHINGTON MEMORIAL HWY, GLOUCESTER, VA 23061-4162
(804) 693-5068
(804) 639-7407
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904001982
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
250210
ANTHEM
VA
05
—
250210
—
VA
01
—
250212
HEALTHKEEPERS
VA
05
—
250212
—
VA
05
—
O85330
—
VA
Enumeration date
04/19/2006
Last updated
07/09/2007
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