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NPI Code Detail

MEDICARE: SUSANNA GALLAGHER LCSW

MEDICARE: SUSANNA GALLAGHER 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
11041C0700XClinical Social WorkerL17965OR

General Provider Information

NPI Number : 1477100691
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSANNA GALLAGHER LCSW
Provider Business Mailing Address
First Line : 2577 NE COURTNEY DR
Second Line :
City : BEND
State : OR
Zip : 97701-7752
Country : US
Telephone Number : 541-322-7500
Fax Number : 541-322-7565
Provider Business Practice Location Address
First Line : 2577 NE COURTNEY DR
Second Line :
City : BEND
State : OR
Zip : 97701-7752
Country : US
Telephone Number : 541-322-7500
Fax Number : 541-322-7565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2019
Last Update Date : 05/08/2026

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Directions to “ SUSANNA GALLAGHER LCSW” Practice Location

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