Active NPI
Maureen Gallagher, LCSW
- Clinical Social Worker
- Fairfax, VA
National Provider Identifier
1831301084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904004294
- Practice address
- 3959 Pender Dr
Suite 320
Fairfax, VA 22030-6041 - Phone
- (703) 352-3822
- Fax
- (703) 385-8353
- NPI assigned
- May 3, 2007
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904004294 | VA | Primary |
Addresses
Primary practice location
3959 Pender Dr
Suite 320
Fairfax, VA 22030-6041
Mailing address
13850 Wakley CT
Centreville, VA 20121-3073
Phone (703) 587-2199
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 |
|---|---|---|---|
| 0904004294 | VA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child & Family Counseling Group | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831301084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13850 WAKLEY CT",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "201213073",
"telephone_number": "703-587-2199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3959 PENDER DR",
"address_2": "SUITE 320",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220306041",
"telephone_number": "703-352-3822",
"fax_number": "703-385-8353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLAGHER",
"first_name": "MAUREEN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904004294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.