Jacqueline M. Gallios, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00578100 Issued in NJ

Practice address

579 Pompton Avenue
Suite #106
Cedar Grove, NJ 07009-1720

Phone

(201) 647-9199

NPI assigned

Jul 20, 2016

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

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1073966461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 POMPTON AVENUE",
            "address_2": "SUITE #106",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091720",
            "telephone_number": "201-647-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 POMPTON AVENUE",
            "address_2": "SUITE #106",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091720",
            "telephone_number": "201-647-9199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "567 Park Avenue",
            "address_2": "Suite #204",
            "address_purpose": "LOCATION",
            "city": "Scotch Plains",
            "state": "NJ",
            "postal_code": "070761754",
            "country_code": "US",
            "telephone_number": "201-647-9199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLIOS",
        "first_name": "JACQUELINE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00578100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Patrick Filiaci, PH.D.
• Christina Dawn Formato, LSW
• Forza Psychotherapy and Counseling, LLC
• Sean Patrick Foster
• Nathalie Gagneux, OTR/L
• Senthamarai Gandhi, M.D
• Shrilekha Gandhi
• Colette Dawn Gandolfo, C.O.T.A
• Jayme Ganey, LPC
• Felicia Gardner, LCSW

• Clinical Psychologist in Cedar Grove, NJ
• Providers in Cedar Grove, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.