Provider Demographics
NPI:1861598484
Name:KILGALEN ASSOCIATES PA
Entity type:Organization
Organization Name:KILGALEN ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR SR CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:KILGALEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW C
Authorized Official - Phone:410-877-7207
Mailing Address - Street 1:1716 HARFORD RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047
Mailing Address - Country:US
Mailing Address - Phone:410-877-7207
Mailing Address - Fax:410-877-7224
Practice Address - Street 1:1716 HARFORD RD
Practice Address - Street 2:SUITE 204
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047
Practice Address - Country:US
Practice Address - Phone:410-877-7207
Practice Address - Fax:410-877-7224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD033741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKC83OtherBLUE CROSS BLUE SHIELD
MDT460OtherBLUE CHOICE
MD114MMedicare ID - Type Unspecified
MDKC83OtherBLUE CROSS BLUE SHIELD