Byron Galloway, LMFT
Individual provider Active NPI Marriage & Family Therapist · Jackson, MS
NPI 1316255367 · NPPES record last updated Sep 23, 2010
Key facts
- NPI
- 1316255367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- T0045 (MS)
- Practice address
- 1855 Lakeland Dr
Suite R-204
Jackson, MS 39216-4913 - Phone
- (601) 982-5376
- Fax
- (601) 982-5377
- NPI assigned
- Sep 23, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T0045 | MS | MD | Marriage & Family Therapist |
Interoperability endpoints
- imaginebehavioralhealth.byrongalloway@139031.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | T0045 | MS | Yes |
Addresses
Primary practice location
1855 Lakeland Dr
Suite R-204
Jackson, MS 39216-4913
Mailing address
1855 Lakeland Dr
Suite R-204
Jackson, MS 39216-4913
Phone (601) 982-5376
Other providers in Jackson, MS
- Viswanath Gajula
- Laura Isabel Galarza
- Candace Gallager
- Allison Gallagher
- Robert Galli
- Kevin L Galloway V
- Abigail Gamble
- Antonio Gamble
- Kirsten Rosetta Gambrell
- Deep Asit Gandhi
All providers in Jackson, MS · Marriage & Family Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.