Healthcare Provider Details

I. General information

NPI: 1982332110
Provider Name (Legal Business Name): CATHERINE ANN GALLAGHER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 E BURNSIDE ST
PORTLAND OR
97214-1831
US

IV. Provider business mailing address

7803 W 159TH ST
TINLEY PARK IL
60477-1343
US

V. Phone/Fax

Practice location:
  • Phone: 503-953-0310
  • Fax:
Mailing address:
  • Phone: 708-719-4288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC11452
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: