Provider Demographics
NPI:1083197990
Name:FALKNER, VIRGINIA M (LMSW)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:M
Last Name:FALKNER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 3RD ST FL 1
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-5323
Mailing Address - Country:US
Mailing Address - Phone:518-573-6622
Mailing Address - Fax:
Practice Address - Street 1:676 CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-2216
Practice Address - Country:US
Practice Address - Phone:518-475-6715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104251104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker