Healthcare Provider Details

I. General information

NPI: 1265921563
Provider Name (Legal Business Name): ANTHONY J.L GALYON LCDCIII, LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1154 N COURT ST
CIRCLEVILLE OH
43113-1304
US

IV. Provider business mailing address

303 OFFNERE ST
PORTSMOUTH OH
45662-4655
US

V. Phone/Fax

Practice location:
  • Phone: 800-321-8293
  • Fax:
Mailing address:
  • Phone: 740-876-9369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.1701251
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCDCIII.161592
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: