Provider Demographics
NPI:1114776655
Name:GALASSO, JAMIE (MSW, LCASA)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:GALASSO
Suffix:
Gender:F
Credentials:MSW, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4117 CARROLL RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-9347
Mailing Address - Country:US
Mailing Address - Phone:570-926-5323
Mailing Address - Fax:
Practice Address - Street 1:102 CHESTNUT DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-6804
Practice Address - Country:US
Practice Address - Phone:336-886-5594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-30009101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)