Kaitlin Tara Gallucci, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

113763 Issued in NY

Practice address

21 Grand St
Newburgh, NY 12550-5628

Phone

(845) 562-7244

NPI assigned

Jan 31, 2022

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

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Access Supports for Living IncGroup PAC ID 8729992730, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Access: Supports for Living Inc

  • Multi-Specialty Clinic/Center
  • Middletown, NY
  • NPI 1528174976
  Medicare reassignment Care Compare group NPD
• Access: Supports for Living Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Middletown, NY
  • NPI 1790326320
  NPD

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1730832734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 CHURCH ST APT 4",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611505",
            "telephone_number": "845-706-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GRAND ST",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505628",
            "telephone_number": "845-562-7244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Fortune Rd W",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NY",
            "postal_code": "109411625",
            "country_code": "US",
            "telephone_number": "845-692-4454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31 Church St Apt 4",
            "address_purpose": "LOCATION",
            "city": "New Paltz",
            "state": "NY",
            "postal_code": "125611505",
            "country_code": "US",
            "telephone_number": "845-706-1474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLUCCI",
        "first_name": "KAITLIN",
        "middle_name": "TARA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "113763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danny Anthony Galasso, CASAC
• Angelyn Elizabeth Galati, LCSW
• Bryan Alexander Galecki, RPH
• Lisa Marie Gallo, CASAC
• Vincent Francis Gallo Jr., DPM
• Alesia Galvao
• Patricia Gannon
• Michael Garda
• Diego Garrido, CRNA
• Daniel Gasperini, D.D.S

• Social Worker in Newburgh, NY
• Providers in Newburgh, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.