Provider Demographics
NPI:1033433768
Name:GALLAGHER, CASEY CARNEY (LMHC)
Entity Type:Individual
Prefix:MS
First Name:CASEY
Middle Name:CARNEY
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WARREN AVE STE 2L-A
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-3826
Mailing Address - Country:US
Mailing Address - Phone:401-305-0080
Mailing Address - Fax:401-574-2033
Practice Address - Street 1:400 WARREN AVE STE 2L-A
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-3826
Practice Address - Country:US
Practice Address - Phone:401-305-0080
Practice Address - Fax:401-574-2033
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00737101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1033433768Medicaid