Timothy Gallagher, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05867500 Issued in NJ

Practice address

340 Magnolia Cir
Tyndall Afb, FL 32403-5604

Phone

(850) 283-7511

NPI assigned

Mar 2, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1551484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1093273625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAGNOLIA CIR",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "324035604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MAGNOLIA CIR",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "324035604",
            "telephone_number": "850-283-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "TIMOTHY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-02",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06231600",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05867500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• An Thuy Duong, MD
• Lori Elliott, DENTAL HYGIENIST
• Shauna M. Ezell, PHD, LCSW
• Tyler Faulkner, LAT, ATC, CES
• Zachary Flink, D.D.S.
• Mordecai Christopher Garcia
• Michelle Gautreaux, RDN/LDN
• Pamela Suzanne Gilley, LCSW
• Dominique D. Gougis, PSY.D.
• Jimbell Gray, IDMT

• Clinical Social Worker in Tyndall Afb, FL
• Providers in Tyndall Afb, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.