| Doctor Name: | MR. CHARLES JUSTIN GALLOWAY |
| NPI Number: | 1972981397 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.ED., LPC |
| License Number: | LPC007117 |
| Business Practice Address: | 300 Oak St Suite 203 St Simons Island, GA - 315224738 |
| Business Phone Number: | 9122684750 |
| Business Fax Number: | |
| Mailing Address: | 527 Postell Dr, ST SIMONS ISLAND |
| State: | GA |
| Postal Code: | 315221804 |
| Phone Number: | 9126024161 |
| Fax Number: | |
| NPI Enumeration Date: | 05/18/2015 |
| NPI Last Update Date: | 05/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | LPC007117 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |