David Gallagher, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

009349 Issued in CT

Practice address

82 Main St
Windsor Locks, CT 06096-2325

Phone

(860) 254-5127

Fax

(860) 310-4235

NPI assigned

Dec 5, 2019

Last updated

Dec 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Eastern Services & Camp Simon LLC

  • Professional Counselor
  • Windsor Locks, CT
  • NPI 1538582739
  NPD

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1508403874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 MAIN ST",
            "city": "WINDSOR LOCKS",
            "state": "CT",
            "postal_code": "060962325",
            "telephone_number": "860-254-5127",
            "fax_number": "860-310-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 MAIN ST",
            "city": "WINDSOR LOCKS",
            "state": "CT",
            "postal_code": "060962325",
            "telephone_number": "860-254-5127",
            "fax_number": "860-310-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "DAVID",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-05",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "assistant@campsimon.net",
            "affiliation": "N",
            "endpointDescription": "counseling office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "82 Main St",
            "city": "Windsor Locks",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060962325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "assistant@campsimon.net",
            "affiliation": "N",
            "endpointDescription": "counseling office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "82 Main St",
            "city": "Windsor Locks",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060962325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Windsor Locks, CT
• Providers in Windsor Locks, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.