Healthcare Provider Details

I. General information

NPI: 1588951727
Provider Name (Legal Business Name): ROBERT M. GALLAGHER LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2011
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 MAGNOLIA WAY
BRIDGEWATER MA
02324-2195
US

IV. Provider business mailing address

83 MAGNOLIA WAY
BRIDGEWATER MA
02324-2195
US

V. Phone/Fax

Practice location:
  • Phone: 781-635-6351
  • Fax:
Mailing address:
  • Phone: 781-635-6351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number126020
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: