| Kathleen Galasso Lcsw | |
|
339 Canterbury Ln Wyckoff NJ 07481-2305 | |
| (201) 954-5552 | |
| Not Available |
| Full Name | Kathleen Galasso Lcsw |
|---|---|
| Speciality | Clinic/Center |
| Location | 339 Canterbury Ln, Wyckoff, New Jersey |
| Authorized Official Name and Position | Kathleen Galasso (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2019545552 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen Galasso Lcsw 339 Canterbury Ln Wyckoff NJ 07481-2305 Ph: (201) 954-5552 | Kathleen Galasso Lcsw 339 Canterbury Ln Wyckoff NJ 07481-2305 Ph: (201) 954-5552 |
| NPI Number | 1629640883 |
|---|---|
| Provider Enumeration Date | 07/15/2021 |
| Last Update Date | 07/21/2021 |
| Certification Date | 07/21/2021 |
| Medicare PECOS PAC ID | 0648676262 |
|---|---|
| Medicare Enrollment ID | O20210908000628 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629640883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kathleen S Galasso |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003306689 PECOS PAC ID: 7810944394 Enrollment ID: I20050406000915 |
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