Active NPI
Tracy E Gallagher, LSW
- Mental Health Counselor
- Medina, OH
National Provider Identifier
1538529425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- S.1502552
- Practice address
- 246 Northland Dr Ste 200a
Medina, OH 44256-3440 - Phone
- (330) 725-9195
- Fax
- (330) 725-9187
- NPI assigned
- Mar 4, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | S.1502552 | OH | Primary |
Addresses
Primary practice location
246 Northland Dr Ste 200a
Medina, OH 44256-3440
Mailing address
246 Northland Dr Ste 200a
Medina, OH 44256-3440
Phone (330) 725-9195
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13779151 | Other | OH | CAQH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| S.1502552 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457049600000",
"number": "1538529425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "246 NORTHLAND DR STE 200A",
"city": "MEDINA",
"state": "OH",
"postal_code": "442563440",
"telephone_number": "330-725-9195",
"fax_number": "330-725-9187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "246 NORTHLAND DR STE 200A",
"city": "MEDINA",
"state": "OH",
"postal_code": "442563440",
"telephone_number": "330-725-9195",
"fax_number": "330-725-9187"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLAGHER",
"first_name": "TRACY",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-04",
"last_updated": "2016-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "S.1502552",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "13779151",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medina, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.