Organization
GALLEGOS COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH GALLEGOS LISW (OWNER)
(641) 781-0770
Entity
Organization
Contact information
Practice address
807 4TH AVE, GRINNELL, IA 50112-2042
(641) 781-0770
(641) 316-8178
Mailing address
1404 BROAD ST, GRINNELL, IA 50112-1421
(641) 781-0770
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
008368
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008368
LISW LICENSE
IA
01
—
1740240456
TYPE 1 NPI
—
01
—
18431
LCSW LICENSE
CA
Enumeration date
07/27/2018
Last updated
07/27/2018
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