Provider Demographics
NPI:1023727658
Name:SHERIFFA GALLWEY, LCSW, PLLC
Entity type:Organization
Organization Name:SHERIFFA GALLWEY, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERIFFA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLWEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:646-713-4158
Mailing Address - Street 1:88 ROXBORO DRIVE, PALM COAST, FL, USA
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164
Mailing Address - Country:US
Mailing Address - Phone:646-713-4158
Mailing Address - Fax:
Practice Address - Street 1:88 ROXBORO DRIVE, PALM COAST, FL, USA
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164
Practice Address - Country:US
Practice Address - Phone:646-713-4158
Practice Address - Fax:845-623-0149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-22
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty