Provider Demographics
NPI:1063143238
Name:GALLIGAN, CHERYL LYNNE (LPC, LMHC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNNE
Last Name:GALLIGAN
Suffix:
Gender:
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 OLD FARMS RD
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-2240
Mailing Address - Country:US
Mailing Address - Phone:516-639-7750
Mailing Address - Fax:
Practice Address - Street 1:670 MAIN ST S STE B206798
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-3738
Practice Address - Country:US
Practice Address - Phone:203-263-3175
Practice Address - Fax:516-280-7286
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-20
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005921101YP2500X
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty