Provider Demographics
NPI:1215692769
Name:FALSO, GILDA MARY (LCMHCA)
Entity type:Individual
Prefix:MRS
First Name:GILDA
Middle Name:MARY
Last Name:FALSO
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:MISS
Other - First Name:GILDA
Other - Middle Name:MARY
Other - Last Name:MANTELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3220 BLUE JAY CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-6916
Mailing Address - Country:US
Mailing Address - Phone:910-512-6764
Mailing Address - Fax:
Practice Address - Street 1:1437 MILITARY CUTOFF RD STE 200
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-3638
Practice Address - Country:US
Practice Address - Phone:910-240-3392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16436101YA0400X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional