Provider Demographics
NPI:1609106806
Name:GALLANT, NANCY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:GALLANT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 CENTRAL AVE
Mailing Address - Street 2:SUITE 316
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3703
Mailing Address - Country:US
Mailing Address - Phone:727-642-5982
Mailing Address - Fax:
Practice Address - Street 1:535 CENTRAL AVE
Practice Address - Street 2:SUITE 316
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3703
Practice Address - Country:US
Practice Address - Phone:727-642-5982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00004221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical