Provider Demographics
NPI:1912785791
Name:GALLO, JAMES ERNEST (LPC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ERNEST
Last Name:GALLO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 HAMBURG TPKE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4032
Mailing Address - Country:US
Mailing Address - Phone:908-405-6548
Mailing Address - Fax:
Practice Address - Street 1:400 RIVERFRONT BLVD APT 303
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-3607
Practice Address - Country:US
Practice Address - Phone:973-618-6955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00966200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health