Mellissa M Gallegos

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

2424 Heritage CT SW Ste 200
Olympia, WA 98502-6046

Phone

(360) 810-1547

NPI assigned

Sep 9, 2020

Last updated

Apr 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mellissa M Storey Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Basics Northwest

  • Community/Behavioral Health Agency
  • Lacey, WA
  • NPI 1396179545
  NPD (past)

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1518572312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2643 10TH CT SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985012057",
            "telephone_number": "509-850-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 HERITAGE CT SW STE 200",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985026046",
            "telephone_number": "360-810-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "MELLISSA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELLISSA",
            "last_name": "STOREY",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffany Galindo, LMP
• Melissa Jo Gallardo, NP
• Cynthia Gallegos
• Laura Gallegos
• Meagan Marina Gallegos, LICSW
• Andrea Gallo
• Andrew Galpin, PHD, CSCS
• Christine Keller Galvin, MA
• Christopher Steven Galvin, L.M.P
• Kerry L Gamble, FNP

• Behavior Technician in Olympia, WA
• Providers in Olympia, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.