MEDICARE: MISS HEATHER MARIE GILLIGAN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1336521459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS HEATHER MARIE GILLIGAN LCSW

Provider Business Mailing Address
First Line	:	59 S GRAND ST
Second Line	:
City	:	WESTBURY
State	:	NY
Zip	:	11590-4344
Country	:	US
Telephone Number	:	631-871-1388
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 WALT WHITMAN RD
Second Line	:
City	:	HUNTINGTON STATION
State	:	NY
Zip	:	11746-4112
Country	:	US
Telephone Number	:	516-508-3579
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2015
Last Update Date	:	05/12/2025

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