Active NPI
Colleen Patricia Gallagher, MS CCC/SLP
- Speech-Language Pathologist
- Cambridge, MA
National Provider Identifier
1700031101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SL008856
- Practice address
- 100 Memorial Dr
Cambridge, MA 02142-1314 - Phone
- (717) 979-0570
- NPI assigned
- Nov 26, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SL008856 | PA | Primary |
| Speech-Language Pathologist | 235Z00000X | 7386 | MA |
Addresses
Primary practice location
100 Memorial Dr
Cambridge, MA 02142-1314
Mailing address
5 Middlesex Avenue
Somerville, MA 02145
Phone (717) 979-0570
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7386 | MA | MD | Physical Therapist |
| SL008856 | PA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300752000000",
"number": "1700031101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 MIDDLESEX AVENUE",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "02145",
"telephone_number": "717-979-0570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MEMORIAL DR",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021421314",
"telephone_number": "717-979-0570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLAGHER",
"first_name": "COLLEEN",
"middle_name": "PATRICIA",
"name_prefix": "Miss",
"credential": "MS CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-26",
"last_updated": "2011-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PA",
"license": "SL008856",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "7386",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.