Provider Demographics
NPI:1407959646
Name:GALLO, ANNA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:
Last Name:GALLO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-120 QUEENS BLVD
Mailing Address - Street 2:A COMPREHENSIVE COUNSELING CTR LLC
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374
Mailing Address - Country:US
Mailing Address - Phone:718-830-0246
Mailing Address - Fax:718-830-9088
Practice Address - Street 1:98-120 QUEENS BLVD
Practice Address - Street 2:A COMPREHENSIVE COUNSELING CTR LLC
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-830-0246
Practice Address - Fax:718-830-9088
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0379671104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
7346878OtherGHI
P3598293OtherOXFORD
P3598293OtherOXFORD
7346878OtherGHI