Provider Demographics
NPI:1588719058
Name:FAULKNER, MICHAEL J (LCSW)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:FAULKNER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BATTERY PARK AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2720
Mailing Address - Country:US
Mailing Address - Phone:828-231-1001
Mailing Address - Fax:828-658-3995
Practice Address - Street 1:20 BATTERY PARK AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2720
Practice Address - Country:US
Practice Address - Phone:828-231-1001
Practice Address - Fax:828-658-3995
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC130KKOtherBCBS
NC6002271Medicaid
NC6002271Medicaid