Provider Demographics
NPI:1063453496
Name:GALLAGHER, PATRICK (MS, LPC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-8626
Mailing Address - Country:US
Mailing Address - Phone:717-851-6340
Mailing Address - Fax:717-851-6349
Practice Address - Street 1:1101 EDGAR ST
Practice Address - Street 2:SUITE A
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2862
Practice Address - Country:US
Practice Address - Phone:717-851-1500
Practice Address - Fax:717-851-1515
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000262101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50049351OtherCAPITAL BLUE CROSS
PA646189-01OtherBC/BS OF MD CARE FIRST
PA2236896OtherCIGNA BEHAVIORAL HEALTH
PA801955000OtherMAGELLAN