Individual provider Active NPI

Dawn Marie Gallagher, LADC, BA

  • Addiction (Substance Use Disorder) Counselor
  • Eagan, MN
National Provider Identifier
1871869412
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
303290 Issued in MN
Practice address
3470 Washington Dr
Eagan, MN 55122-1355
Phone
(612) 454-2248
Fax
(651) 454-2972
NPI assigned
Mar 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 303290 MN Primary

Addresses

Primary practice location

3470 Washington Dr
Eagan, MN 55122-1355

Mailing address

550 Main St Ste 230
New Brighton, MN 55112-3274

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
303290MNMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1871869412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MAIN ST STE 230",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551123274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3470 WASHINGTON DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221355",
            "telephone_number": "612-454-2248",
            "fax_number": "651-454-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "credential": "LADC, BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.