=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669367298
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOU C. GALLAGHER, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2025
-----------------------------------------------------
Last Update Date | 06/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 28 S WATER ST STE 307
-----------------------------------------------------
City | BATAVIA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60510-3104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-585-3920
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 356 N WATER ST
-----------------------------------------------------
City | BATAVIA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60510-1968
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-585-3920
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. LOU C GALLAGHER
-----------------------------------------------------
Credential | LCPC
-----------------------------------------------------
Telephone | 630-585-3920
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------