Mark Richard Gallagher, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1026018 Issued in MA

Practice address

173 Chelsea St
Tri City Mental Health Center
Everett, MA 02149

Phone

(781) 388-6224

Fax

(617) 387-9768

NPI assigned

Dec 12, 2006

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

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eliot Community Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Concord, MA
  • NPI 1679648182
  Medicare reassignment NPD
• Eliot Community Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lexington, MA
  • NPI 1932271632
  NPD

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134280423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 SPENCER AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442611",
            "telephone_number": "617-623-5397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 CHELSEA ST",
            "address_2": "TRI CITY MENTAL HEALTH CENTER",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "02149",
            "telephone_number": "781-388-6224",
            "fax_number": "617-387-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1026018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Vincent Freeman, BT
• Kerri Anne Friel-Walsh, M.S., CCC-SLP
• Casey Campbell Frieling, APRN
• Michelle Marie Froc
• Lynn H Galen, M.D.
• Barbara I Gangemi, LMHC
• Xiaohe Gao
• Terrin Morgan Gathers, RN
• Jillian Marie Gauvin
• Gerald R. Grasso DMD,PC

• Clinical Social Worker in Everett, MA
• Providers in Everett, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.