Provider Demographics
NPI:1811222607
Name:JOHN GALLAGHER, LMHC, INC.
Entity Type:Organization
Organization Name:JOHN GALLAGHER, LMHC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-579-2070
Mailing Address - Street 1:114 E NEW ENGLAND AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4338
Mailing Address - Country:US
Mailing Address - Phone:407-579-2070
Mailing Address - Fax:407-895-6155
Practice Address - Street 1:114 E NEW ENGLAND AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4338
Practice Address - Country:US
Practice Address - Phone:407-579-2070
Practice Address - Fax:407-895-6155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-12
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4718101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty