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NPI Code Detail

MEDICARE: BRIAN J GALLAGHER MSW, LCSW

MEDICARE:   BRIAN J GALLAGHER  MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
21041C0700XClinical Social WorkerSW123785PA
31041C0700XClinical Social WorkerCW024673PA

General Provider Information

NPI Number : 1346413093
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN J GALLAGHER MSW, LCSW
Provider Business Mailing Address
First Line : 3102 N HARRISON ST
Second Line :
City : WILMINGTON
State : DE
Zip : 19802-2937
Country : US
Telephone Number : 610-212-0196
Fax Number :
Provider Business Practice Location Address
First Line : 524 N PROVIDENCE RD
Second Line :
City : MEDIA
State : PA
Zip : 19063-3056
Country : US
Telephone Number : 484-440-9416
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2008
Last Update Date : 05/08/2024

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