Provider Demographics
NPI:1326457979
Name:GALLAGHER, EILEEN (LPC)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1193
Mailing Address - Street 2:
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-1193
Mailing Address - Country:US
Mailing Address - Phone:907-752-3010
Mailing Address - Fax:
Practice Address - Street 1:315 SEWARD ST
Practice Address - Street 2:SUITE E
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7524
Practice Address - Country:US
Practice Address - Phone:907-752-3010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK857101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional