Provider Demographics
NPI:1558823310
Name:GALVIN, CARLEEN ELIZABETH
Entity Type:Individual
Prefix:MISS
First Name:CARLEEN
Middle Name:ELIZABETH
Last Name:GALVIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BOARDMAN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-4041
Mailing Address - Country:US
Mailing Address - Phone:774-444-3436
Mailing Address - Fax:
Practice Address - Street 1:35 CONGRESS ST STE 2150C
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-5529
Practice Address - Country:US
Practice Address - Phone:978-744-1585
Practice Address - Fax:978-741-1379
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health