Individual provider Active NPI

Ellen Galligan, LICSW

  • Social Worker
  • Salem, MA
National Provider Identifier
1407339658
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
100373 Issued in MA
Practice address
22 Cleveland Rd
Salem, MA 01970-4415
Phone
(978) 744-9191
NPI assigned
Sep 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 100373 MA Primary

Addresses

Primary practice location

22 Cleveland Rd
Salem, MA 01970-4415

Mailing address

22 Cleveland Rd
Salem, MA 01970-4415
Phone (978) 744-9191

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

State licenses

LicenseStateTypeSpecialty
100373MAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1407339658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CLEVELAND RD",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019704415",
            "telephone_number": "978-744-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 CLEVELAND RD",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019704415",
            "telephone_number": "978-744-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLIGAN",
        "first_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "100373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.