Provider Demographics
NPI:1932746948
Name:FALCINELLI, ANGELICA GRACE (LMSW, LCAT, BC-DMT)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:GRACE
Last Name:FALCINELLI
Suffix:
Gender:F
Credentials:LMSW, LCAT, BC-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W 169TH ST APT 66
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-2910
Mailing Address - Country:US
Mailing Address - Phone:718-971-3772
Mailing Address - Fax:
Practice Address - Street 1:2089 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-2184
Practice Address - Country:US
Practice Address - Phone:212-828-6144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111308-01104100000X
NY002214225600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker