Provider Demographics
NPI:1851486856
Name:GALLAGHER, JOSEPH T (MSW LMHC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:T
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:MSW LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1611
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370
Mailing Address - Country:US
Mailing Address - Phone:360-697-1141
Mailing Address - Fax:360-697-2395
Practice Address - Street 1:20174 FRONT ST
Practice Address - Street 2:FRONT ST CLINIC
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370
Practice Address - Country:US
Practice Address - Phone:360-697-1141
Practice Address - Fax:360-697-2395
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005240101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health