Provider Demographics
NPI:1073788246
Name:GILROY, BRIAN D (LCSW, LMFT, LCADC)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:D
Last Name:GILROY
Suffix:
Gender:M
Credentials:LCSW, LMFT, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 1ST ST
Mailing Address - Street 2:
Mailing Address - City:KEYPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07735-1586
Mailing Address - Country:US
Mailing Address - Phone:908-233-4290
Mailing Address - Fax:
Practice Address - Street 1:68 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1618
Practice Address - Country:US
Practice Address - Phone:908-233-4290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2015-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC007534001041C0700X
NJ37FI00130900106H00000X
NJ37LC00027100101YA0400X
NYR 039990-11041C0700X
NY4161101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)