Individual provider Active NPI

Samuel Gerard Falcone, LCSW

  • Clinical Social Worker
  • Fort Monmouth, NJ
National Provider Identifier
1124118476
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904002363 Issued in VA
Practice address
1075 Stephenson Ave
Patterson Army Health Clinic, Attn: Credentials Office
Fort Monmouth, NJ 07703-1518
Phone
(732) 532-0182
Fax
(732) 532-0194
NPI assigned
Oct 14, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904002363 VA Primary

Addresses

Primary practice location

1075 Stephenson Ave
Patterson Army Health Clinic, Attn: Credentials Office
Fort Monmouth, NJ 07703-1518

Mailing address

13030 Hunterbrook Dr
Woodbridge, VA 22192-2468
Phone (703) 915-5718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904002363VAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124118476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13030 HUNTERBROOK DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922468",
            "telephone_number": "703-915-5718",
            "fax_number": "703-494-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 STEPHENSON AVE",
            "address_2": "PATTERSON ARMY HEALTH CLINIC, ATTN: CREDENTIALS OFFICE",
            "city": "FORT MONMOUTH",
            "state": "NJ",
            "postal_code": "077031518",
            "telephone_number": "732-532-0182",
            "fax_number": "732-532-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALCONE",
        "first_name": "SAMUEL",
        "middle_name": "GERARD",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Monmouth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.