Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mark J Kilgallon, LICSW

Individual provider Clinical Social Worker · NPI 1881739761

Mark J Kilgallon, LICSW is a Clinical Social Worker in Brattleboro, Vermont. Qualified in 2001, 25 years ago. Practices as a sole proprietor. Licensed in Massachusetts.

Years since qualifying
25
Licensed in
MA
In the registry since
2007
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

60 Terrace St
Brattleboro, VT 05301-3105
Phone: (413) 522-9158
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 212047 (MA)

Record details

NPI number1881739761
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedFebruary 20, 2007
Last updated in NPPESMarch 20, 2023
Certification dateMarch 20, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Accepts Medicare assignment Not indicated

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