Provider Demographics
NPI:1457848012
Name:GALARRAGA, MICHAEL JEREMY (LPC, ATR-BC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JEREMY
Last Name:GALARRAGA
Suffix:
Gender:M
Credentials:LPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 S 16TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3332
Mailing Address - Country:US
Mailing Address - Phone:347-351-9242
Mailing Address - Fax:
Practice Address - Street 1:245 S 16TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3332
Practice Address - Country:US
Practice Address - Phone:347-351-9242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007262101Y00000X
PAPC012094101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor