Provider Demographics
NPI:1124118476
Name:FALCONE, SAMUEL GERARD (LCSW)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:GERARD
Last Name:FALCONE
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Gender:M
Credentials:LCSW
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Mailing Address - Street 1:13030 HUNTERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2468
Mailing Address - Country:US
Mailing Address - Phone:703-915-5718
Mailing Address - Fax:703-494-0735
Practice Address - Street 1:1075 STEPHENSON AVE
Practice Address - Street 2:PATTERSON ARMY HEALTH CLINIC, ATTN: CREDENTIALS OFFICE
Practice Address - City:FORT MONMOUTH
Practice Address - State:NJ
Practice Address - Zip Code:07703-1518
Practice Address - Country:US
Practice Address - Phone:732-532-0182
Practice Address - Fax:732-532-0194
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
VA09040023631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical