Provider Demographics
NPI:1194576637
Name:GALLO, JULIA (MA, LPC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:GALLO
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 W OAKCREST AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1714
Mailing Address - Country:US
Mailing Address - Phone:609-781-5280
Mailing Address - Fax:
Practice Address - Street 1:408 BETHEL RD STE C-2
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2184
Practice Address - Country:US
Practice Address - Phone:609-788-0199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00600800101YM0800X
NJ37PC01107800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty