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General NPI Number Information
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NPI Number | 1881204006
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Entity Type | Individual
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Provider Name | KELLY GALLAGHER LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 95 GLEN WILD RD UNIT 101
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City | ROCK HILL
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State | NY
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Zip | 12775-6722
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Country | US
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Telephone | 845-428-7141
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Fax |
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Provider Business Mailing Address
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Address Line | PROFESSIONAL OFFICE OF KELLY A. GALLAGHER, LCSW 10 ALPINE DRIVE #1003
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City | WOODRIDGE
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State | NY
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Zip | 12789
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Country | US
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Telephone | 845-282-9149
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 098694
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License Number State | NY
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