Individual provider Active NPI

Kieran Gallogly, CASAC

  • Addiction (Substance Use Disorder) Counselor
  • Mineola, NY
National Provider Identifier
1437572666
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
20563 Issued in NY
Practice address
110 Main St
Mineola, NY 11501-4000
Phone
(516) 747-5644
NPI assigned
Jan 23, 2014
Last updated
May 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 20563 NY Primary

Addresses

Primary practice location

110 Main St
Mineola, NY 11501-4000

Mailing address

110 Main St
Mineola, NY 11501-4000
Phone (516) 747-5644

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
20563NYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1437572666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MAIN ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014000",
            "telephone_number": "516-747-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAIN ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014000",
            "telephone_number": "516-747-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLOGLY",
        "first_name": "KIERAN",
        "name_prefix": "Mrs.",
        "credential": "CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-23",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "20563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.