Jon D. Gallagher, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LC4988 Issued in ME

Practice address

67 Eustis Pkwy
Waterville, ME 04901-5173

Phone

(207) 873-2136

Fax

(207) 872-4522

NPI assigned

Sep 1, 2011

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1134400369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MAPLE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043304705",
            "telephone_number": "207-458-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 EUSTIS PKWY",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015173",
            "telephone_number": "207-873-2136",
            "fax_number": "207-872-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "JON",
        "middle_name": "D.",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC4988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy J Gagne, MD
• Danielle Paige Gagnon, M.D.
• Jeffrey Gagnon, PA
• Paulette L. Gagnon, R.N.
• Steven Raymond Gagnon, D.C.
• Fernald Timothy Garland, PA-C
• John Garofalo, MD
• Christopher Garrison, ED.D
• Gary Rasmussen, PH.D. Clinical Psychologist PA
• Patricia D Gathman, PA

• Addiction (Substance Use Disorder) Counselor in Waterville, ME
• Providers in Waterville, ME by specialty
• Addiction (Substance Use Disorder) Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.