Provider Demographics
NPI:1497884886
Name:GALLANT, JUDITH (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:GALLANT
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 1:8720 GEORGIA AVE
Mailing Address - Street 2:SUITE 905
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3638
Mailing Address - Country:US
Mailing Address - Phone:301-587-2552
Mailing Address - Fax:301-587-1787
Practice Address - Street 1:8720 GEORGIA AVE
Practice Address - Street 2:SUITE 905
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3638
Practice Address - Country:US
Practice Address - Phone:301-587-2552
Practice Address - Fax:301-587-1787
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD40301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical