Provider Demographics
NPI:1497515985
Name:JAY GALLAGHER THERAPY LLC
Entity Type:Organization
Organization Name:JAY GALLAGHER THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC, LCMHC
Authorized Official - Phone:978-712-4920
Mailing Address - Street 1:119 WINTHROP AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-2050
Mailing Address - Country:US
Mailing Address - Phone:978-712-4920
Mailing Address - Fax:
Practice Address - Street 1:119 WINTHROP AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2050
Practice Address - Country:US
Practice Address - Phone:978-712-4920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty