Provider Demographics
NPI:1770293292
Name:GALLIMORE, DENISE (LMSW)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:GALLIMORE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 LARAMIE LN
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-5383
Mailing Address - Country:US
Mailing Address - Phone:718-924-3789
Mailing Address - Fax:
Practice Address - Street 1:305 LARAMIE LN
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-5383
Practice Address - Country:US
Practice Address - Phone:189-243-7897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104448104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker