Provider Demographics
NPI:1588772495
Name:GALLAGHER, PATRICK FRANCIS (LCSW)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:FRANCIS
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2100 WASHINGTON BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-5717
Mailing Address - Country:US
Mailing Address - Phone:703-228-5201
Mailing Address - Fax:703-228-1050
Practice Address - Street 1:14170 NEWBROOK DR STE 200
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-2233
Practice Address - Country:US
Practice Address - Phone:703-961-5475
Practice Address - Fax:703-961-9365
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904006056101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)