# TRIAD ADOLESCENT SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316368749
- **Authorized official:** DR. GILLIAN CAROL GALEN PSYD (CLINICAL DIRECTOR)
- **Authorized official phone:** (617) 290-9432

## Contact information

- **Practice address:** 363 MASS AVE, SUITE 204, LEXINGTON, MA 02420
- **Practice address phone:** (781) 864-4814
- **Mailing address:** 363 MASS AVE, SUITE 204, LEXINGTON, MA 02420
- **Mailing address phone:** (781) 864-4814

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 2353 | MA | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 9159 | MA | Yes |

## Other

- **Enumeration date:** 01/03/2014
- **Last updated:** 01/03/2014