Provider Demographics
NPI:1962856971
Name:GALLAGHER, HEATHER
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3329 DURHAM CHAPEL HILL BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2663
Mailing Address - Country:US
Mailing Address - Phone:919-419-0229
Mailing Address - Fax:919-490-3708
Practice Address - Street 1:3329 DURHAM CHAPEL HILL BLVD
Practice Address - Street 2:STE 201
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2663
Practice Address - Country:US
Practice Address - Phone:919-419-0229
Practice Address - Fax:919-490-3708
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20654101YA0400X
NCA11944101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health