Provider Demographics
NPI:1699032847
Name:SANDRA GALGANO, LCSW, INC
Entity Type:Organization
Organization Name:SANDRA GALGANO, LCSW, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALGANO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:754-224-8456
Mailing Address - Street 1:19486 S WHITEWATER AVE
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33332-2442
Mailing Address - Country:US
Mailing Address - Phone:754-224-8456
Mailing Address - Fax:954-217-3629
Practice Address - Street 1:300 S PINE ISLAND RD
Practice Address - Street 2:SUITE 262
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2673
Practice Address - Country:US
Practice Address - Phone:754-224-8456
Practice Address - Fax:954-217-3629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW89981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEM271AMedicare Oscar/Certification