Healthcare Provider Details

I. General information

NPI: 1861718983
Provider Name (Legal Business Name): SUSAN E GALVIN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 HILLSIDE VILLAGE DR
WEST BOYLSTON MA
01583-2456
US

IV. Provider business mailing address

63 HILLSIDE VILLAGE DR
WEST BOYLSTON MA
01583-2456
US

V. Phone/Fax

Practice location:
  • Phone: 954-366-9978
  • Fax:
Mailing address:
  • Phone: 978-895-2855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6414
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: