William Gallagher, CASAC-T, CRPA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

38573 Issued in NY

Practice address

770 Grand Blvd Ste 17
Deer Park, NY 11729-5725

Phone

(631) 919-7294

NPI assigned

May 10, 2024

Last updated

May 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1720836984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5616 SEABURY ST APT 1C",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734868",
            "telephone_number": "347-781-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 GRAND BLVD STE 17",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117295725",
            "telephone_number": "631-919-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "WILLIAM",
        "credential": "CASAC-T, CRPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NY",
            "license": "CRPA-5510",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "38573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demetrios Gorgios Fuiaxis
• Morgan Lee Fusco, OTR
• Lisa Marie Gaeta, RN
• Robert Gaied
• Tara M Gajewski, LMSW
• Mila Gallego
• Jeanne S Ganz, OTR
• Christine E Gardner, MS, BCBA, LBA
• Christina Gasiewski, OTR/L
• Danielle Lynn Geiger, R.D.

• Addiction (Substance Use Disorder) Counselor in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.