Individual
MR. JOHN MICHAEL WALSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC,CADC
Contact information
Practice address
2052 3RD AVE, ROCK ISLAND, IL 61201-8803
(309) 794-1097
(309) 794-1208
Mailing address
2052 3RD AVE, ROCK ISLAND, IL 61201-8803
(309) 794-1097
(309) 794-1208
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
180009182
IL
Other
Enumeration date
12/21/2012
Last updated
07/02/2014
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