Provider Demographics
NPI:1417344185
Name:GALLAGHER, SANDRA LEU (LCSW-C)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LEU
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-7704
Mailing Address - Country:US
Mailing Address - Phone:443-869-4909
Mailing Address - Fax:410-534-8737
Practice Address - Street 1:7000 HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-7704
Practice Address - Country:US
Practice Address - Phone:443-869-4909
Practice Address - Fax:410-534-8737
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD099371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical