Provider Demographics
NPI:1619676400
Name:GALLACHER, KIERSTEN (LMHC-LP)
Entity Type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:
Last Name:GALLACHER
Suffix:
Gender:F
Credentials:LMHC-LP
Other - Prefix:
Other - First Name:SHIERSTEN
Other - Middle Name:S
Other - Last Name:GALLACHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC-LP
Mailing Address - Street 1:45 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-1340
Mailing Address - Country:US
Mailing Address - Phone:908-343-5088
Mailing Address - Fax:
Practice Address - Street 1:444 E BOSTON POST RD STE 206
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3704
Practice Address - Country:US
Practice Address - Phone:201-830-1518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18-P117408-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health