Provider Demographics
NPI:1740582881
Name:GALUSHA, CARLA SWICK (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:SWICK
Last Name:GALUSHA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 GULF FWY S STE B
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6769
Mailing Address - Country:US
Mailing Address - Phone:804-894-2371
Mailing Address - Fax:804-299-5176
Practice Address - Street 1:2210 LILYGLEN CT
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3973
Practice Address - Country:US
Practice Address - Phone:804-894-2371
Practice Address - Fax:804-299-5176
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
9501103T00000X
VA0810004709103TC0700X
TX39174103TC0700X
AL1641103TF0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic