Provider Demographics
NPI:1023362381
Name:LYNNE GALBALLY LLC
Entity Type:Organization
Organization Name:LYNNE GALBALLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH LYNNE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:GALBALLY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:843-437-2845
Mailing Address - Street 1:1002 ANNA KNAPP EXT
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-5421
Mailing Address - Country:US
Mailing Address - Phone:843-437-2845
Mailing Address - Fax:
Practice Address - Street 1:1002 ANNA KNAPP EXT
Practice Address - Street 2:SUITE 203
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5421
Practice Address - Country:US
Practice Address - Phone:843-437-2845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4636101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty