Jan Agers Gallagher, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH0002177 Issued in FL

Practice address

4741 Atlantic Blvd
Suite B-3
Jacksonville, FL 32207-1114

Phone

(904) 398-1918

Fax

(904) 396-6001

NPI assigned

Jun 18, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jan Elizabeth Agers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1023279452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4741 ATLANTIC BLVD",
            "address_2": "SUITE B-3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322071114",
            "telephone_number": "904-398-1918",
            "fax_number": "904-396-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 ATLANTIC BLVD",
            "address_2": "SUITE B-3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322071114",
            "telephone_number": "904-398-1918",
            "fax_number": "904-396-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "JAN",
        "middle_name": "AGERS",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH0002177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "Z3778",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAN",
            "last_name": "AGERS",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Galicia, PT
• Kevin Galicia
• Diane Criselle J Galindo
• Kristy L Gall, PHARM D
• Amysue Gallagher, LCSW
• Sarah Gallagher, RDN
• Tisha Gallanter, MD
• Erickson Gallardo, PT, DPT
• Pedro Gallardo
• Zachary Tyler-Lee Gallatin, MD

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.