Provider Demographics
NPI:1487968673
Name:GALLAGHER, LORI R (LPC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:R
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 RITNER HWY STE 5
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-9301
Mailing Address - Country:US
Mailing Address - Phone:717-243-1326
Mailing Address - Fax:717-243-0174
Practice Address - Street 1:1710 RITNER HWY STE 5
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-9301
Practice Address - Country:US
Practice Address - Phone:717-243-1326
Practice Address - Fax:717-243-0174
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000365101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC000365OtherLICENSE NUMBER