Provider Demographics
NPI:1073076410
Name:GALLAGHER, SUSAN SMITH (MS, MSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:SMITH
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:MS, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WYNDHAM CLOSE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2111
Mailing Address - Country:US
Mailing Address - Phone:914-263-0278
Mailing Address - Fax:914-831-9865
Practice Address - Street 1:32 WYNDHAM CLOSE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2111
Practice Address - Country:US
Practice Address - Phone:914-263-0278
Practice Address - Fax:914-831-9865
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-11
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR025421-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical