Provider Demographics
NPI:1447466172
Name:KILGALEN, JAMES F (LCSWC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:KILGALEN
Suffix:
Gender:M
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
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:21047-2643
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:21047-2643
Practice Address - Country:US
Practice Address - Phone:410-877-7207
Practice Address - Fax:410-877-7224
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD033741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD221275OtherCOMPSYCH
MDT460OtherBLUE CHOICE
MD900001684001OtherAPS HEALTHCARE
MDKC83OtherCAREFIRST BLUE CROSS BLUE
MD52173890589090OtherCIGNA BEHAVIORAL HEALTH
MD2226337OtherAETNA HEALTH MGMT LLC
MD114MMedicare ID - Type Unspecified