Provider Demographics
NPI:1083149900
Name:FALCO, GABRIELLE ILONA (LCSW, LCADC)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ILONA
Last Name:FALCO
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3171 US HIGHWAY 9 # 312
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2690
Mailing Address - Country:US
Mailing Address - Phone:908-917-3920
Mailing Address - Fax:
Practice Address - Street 1:3171 US HIGHWAY 9 # 312
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2690
Practice Address - Country:US
Practice Address - Phone:908-917-3920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-28
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059055001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical