Healthcare Provider Details

I. General information

NPI: 1063143238
Provider Name (Legal Business Name): CHERYL LYNNE GALLIGAN LPC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2022
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 MAIN ST S STE B206798
WOODBURY CT
06798-3738
US

IV. Provider business mailing address

172 OLD FARMS RD
TORRINGTON CT
06790-2240
US

V. Phone/Fax

Practice location:
  • Phone: 203-263-3175
  • Fax: 516-280-7286
Mailing address:
  • Phone: 516-639-7750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number005921
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: