Individual provider Active NPI

Nicholas P Gallo, PH.D.

  • Psychologist
  • Cleveland, OH
National Provider Identifier
1386045193
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1890 Issued in OH
Practice address
2675 East 30TH Street
Nerc
Cleveland, OH 44115-4115
Phone
(216) 771-6460
Fax
(216) 623-0992
NPI assigned
Sep 11, 2014
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1890 OH Primary

Addresses

Primary practice location

2675 East 30TH Street
Nerc
Cleveland, OH 44115-4115

Mailing address

2675 East 30TH St
Cleveland, OH 44115-4115
Phone (216) 771-6460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1890OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Reintegration Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1386045193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 EAST 30TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441154115",
            "telephone_number": "216-771-6460",
            "fax_number": "216-623-0992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 EAST 30TH STREET",
            "address_2": "NERC",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441154115",
            "telephone_number": "216-771-6460",
            "fax_number": "216-623-0992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLO",
        "first_name": "NICHOLAS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-11",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "1890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.