Individual provider Active NPI

Patricia Gallagher, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1356367072
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR030011-1 Issued in NY
Practice address
24 E 12TH St
Suite 503
New York, NY 10003-4403
Phone
(212) 691-9281
Fax
(212) 645-4349
NPI assigned
Jul 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X PR030011-1 NY Primary

Addresses

Primary practice location

24 E 12TH St
Suite 503
New York, NY 10003-4403

Mailing address

24 E 12TH St
Suite 503
New York, NY 10003-4403
Phone (212) 691-9281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 10, 2023 through Jul 10, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR030011-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356367072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 E 12TH ST",
            "address_2": "SUITE 503",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034403",
            "telephone_number": "212-691-9281",
            "fax_number": "212-645-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 E 12TH ST",
            "address_2": "SUITE 503",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034403",
            "telephone_number": "212-691-9281",
            "fax_number": "212-645-4349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR030011-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.