Healthcare Provider Details

I. General information

NPI: 1619855111
Provider Name (Legal Business Name): AUBREY RAE GALLAGHER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 NEWTON AVE
OAKLYN NJ
08107-1446
US

IV. Provider business mailing address

319 W EVESHAM AVE APT B
MAGNOLIA NJ
08049-1724
US

V. Phone/Fax

Practice location:
  • Phone: 267-980-0760
  • Fax:
Mailing address:
  • Phone: 609-670-4331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01167100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: