Individual provider Active NPI

Elizabeth Galligan, LICSW

  • Clinical Social Worker
  • Concord, MA
National Provider Identifier
1457578163
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113999 Issued in MA
Practice address
330 Baker Ave
Concord, MA 01742-2129
Phone
(978) 287-9380
Fax
(978) 287-9314
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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 113999 MA Primary

Addresses

Primary practice location

330 Baker Ave
Concord, MA 01742-2129

Mailing address

330 Baker Ave
Concord, MA 01742-2129
Phone (978) 287-9380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160624001561 MA Practitioner - Clinical Social Worker 4082905831 Practice locations: Concord, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Concord, MA 01742
Phone (978) 771-0123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113999MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1457578163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BAKER AVE",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422129",
            "telephone_number": "978-287-9380",
            "fax_number": "978-287-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BAKER AVE",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422129",
            "telephone_number": "978-287-9380",
            "fax_number": "978-287-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLIGAN",
        "first_name": "ELIZABETH",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.