Active NPI
Theresa Resotko Galler, LPC
- Professional Counselor
- Goodyear, AZ
National Provider Identifier
1821143785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-10406
- Practice address
- 15324 W Campbell Ave
Goodyear, AZ 85395-6370 - Phone
- (602) 909-0042
- Fax
- (623) 322-3403
- NPI assigned
- Jan 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-10406 | AZ | Primary |
Addresses
Primary practice location
15324 W Campbell Ave
Goodyear, AZ 85395-6370
Mailing address
15324 W Campbell Ave
Goodyear, AZ 85395-6370
Phone (602) 909-0042
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 739451 | Other | AZ | AHCCCS NUMBER |
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 |
|---|---|---|---|
| LPC-10406 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246924800000",
"number": "1821143785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15324 W CAMPBELL AVE",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853956370",
"telephone_number": "602-909-0042",
"fax_number": "623-322-3403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15324 W CAMPBELL AVE",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853956370",
"telephone_number": "602-909-0042",
"fax_number": "623-322-3403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLER",
"first_name": "THERESA",
"middle_name": "RESOTKO",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-23",
"last_updated": "2009-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-10406",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS NUMBER",
"identifier": "739451",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.