Audra Jean Gallogly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

00992163 Issued in CO

Practice address

1120 W South Boulder Rd Ste 101B
Lafayette, CO 80026-8952

Phone

(303) 389-2793

NPI assigned

Aug 5, 2024

Sex

Female

Sole proprietor

Yes

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 CO

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, 1992

Medicare assignment

May accept Medicare assignment

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442
  Medicare reassignment NPD

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1912737842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 LARSON CT",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805167578",
            "telephone_number": "303-669-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W SOUTH BOULDER RD STE 101B",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800268952",
            "telephone_number": "303-389-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLOGLY",
        "first_name": "AUDRA",
        "middle_name": "JEAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "00992163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Gaffaney
• Jennifer Gayle Gaide, DO
• Michael D Gallagher, M.D.
• Nicole Marie Gallagher, M.D.
• Thomas Gallagher, M.D.
• Angel Adrian Galvan, RN
• Zayra Elizabeth Garay Estrada
• Raymond Rafael Garcia
• Rebecca Garcia, RN
• Richard Edward Garde, D.C.

• Clinical Social Worker in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.