MEDICARE: VANESSA FALKENBERG GALLAGHER LPC-S

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	101YP2500X	Professional Counselor	16052	TX

General Provider Information

NPI Number	:	1992041354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA FALKENBERG GALLAGHER LPC-S

Provider Business Mailing Address
First Line	:	9402 HONEYCOMB DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78737-1119
Country	:	US
Telephone Number	:	512-745-1957
Fax Number	:	512-292-9388

Provider Business Practice Location Address
First Line	:	4009 BANISTER LN
Second Line	:	SUITE 356
City	:	AUSTIN
State	:	TX
Zip	:	78704-7040
Country	:	US
Telephone Number	:	512-745-1957
Fax Number	:	512-306-8086

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

Provider Enumeration Date	:	12/12/2012
Last Update Date	:	11/07/2016

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Directions to “ VANESSA FALKENBERG GALLAGHER LPC-S” Practice Location

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