KMG Therapy and Consulting LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8823 Issued in CT

Legal business name

KMG THERAPY AND CONSULTING LLC

Practice address

481 Gold Star Hwy
Suite 301
Groton, CT 06340-6702

Phone

(860) 917-1779

Fax

(860) 447-8122

NPI assigned

Nov 23, 2015

Organization subpart

No

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

Authorized official

Name

Maria M Gallagher, LCSWNPI 1568470573

Title

Member

Phone

(860) 917-1779

Specialties & licenses 1

Addresses

Other identifiers 5

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria Mormay Gallagher, LCSW

  • Clinical Social Worker
  • Groton, CT
  • NPI 1568470573
  NPD (past) Authorized official

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448236800000",
    "number": "1760856181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 E LAKE RD",
            "city": "OAKDALE",
            "state": "CT",
            "postal_code": "063701818",
            "telephone_number": "860-917-1779",
            "fax_number": "860-447-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 GOLD STAR HWY",
            "address_2": "SUITE 301",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406702",
            "telephone_number": "860-917-1779",
            "fax_number": "860-447-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMG THERAPY AND CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-23",
        "last_updated": "2015-11-23",
        "status": "A",
        "authorized_official_last_name": "GALLAGHER",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "860-917-1779",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "8823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS CT BHP",
            "identifier": "0006568",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008056500",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "D300184136",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNCIL FOR AFFORDABLE QUALITY HEALTH (CAQH)",
            "identifier": "13515495",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK (MHN)",
            "identifier": "544181",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert John Kish, OD
• Kla Kemp, LLC
• Kelly Leigh Klein, N.P.
• Lisa M. Klevenow-McGrath, M.ED.MFT
• Jeffrey Alan Klimczak, IDC
• Jordan Knoppert, IDC
• Zachary David Kogut, PHARMD
• Susan B Kohn, F.N.P.
• Alexa Hazel Kolias, AUD
• Michael Korten

• Clinical Social Worker in Groton, CT
• Providers in Groton, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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.