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Individual

MR. ROBERT B GALLIGAN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.ED., LPCC, LADAC

Contact information

Practice address
1400 CARLISLE BLVD NE, ALBUQUERQUE, NM 87110-5658
(505) 332-2377
(505) 274-7279
Mailing address
1400 CARLISLE NE, ALBUQUERQUE, NM 87110-0000
(505) 332-2377
(505) 274-7279

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3442
NM
101YM0800X
Mental Health Counselor
Primary
0080391
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0080391
LPCC
NM
01
3442
LADAC
NM
Enumeration date
05/18/2007
Last updated
12/06/2012
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