Gary M Gallitz, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3830-125 Issued in WI

Practice address

10500 N Port Washington Rd
Mequon, WI 53092-5585

Phone

(262) 240-0427

Fax

(262) 240-0429

NPI assigned

Feb 18, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mequon Labs Inc

  • Clinical Medical Laboratory
  • Mequon, WI
  • NPI 1467612895
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203292800000",
    "number": "1013185586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10137 W RIDGE RD",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301435",
            "telephone_number": "262-337-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 N PORT WASHINGTON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925585",
            "telephone_number": "262-240-0427",
            "fax_number": "262-240-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLITZ",
        "first_name": "GARY",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-18",
        "last_updated": "2008-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3830-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "3830-125",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Froedtert Health Pharmacy LLC (Froedtert Pharmacy 300)
• Froedtert Memorial Lutheran Hospital, Inc. (Froedtert & MCW Mequon Health Center Remote Dispensing Site)
• Kelly Froemke
• Full Life Counseling Center
• Deborah Lee Gall
• Alexandra Galmore
• Masoud Ganji, MD
• Corey F Garber, LPC, SAC-T
• Taylor A Gardner, NP
• Alonzo Garza

• Professional Counselor in Mequon, WI
• Providers in Mequon, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.