Wade M Falconburg, LCSW, MAC, PACT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

223202 Issued in AK

Practice address

PO Box 61416
Fairbanks, AK 99706-1416

Phone

(208) 577-1015

NPI assigned

Jul 13, 2007

Last updated

Jan 1, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• A to Z Family Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pocatello, ID
  • NPI 1992040323
  NPD (past)
• Sitman, Inc.

  • Mental Health Counselor
  • Twin Falls, ID
  • NPI 1992924500

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735689600000",
    "number": "1891994307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61416",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997061416",
            "telephone_number": "208-577-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 61416",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997061416",
            "telephone_number": "208-577-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALCONBURG",
        "first_name": "WADE",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "LCSW, MAC, PACT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2025-01-01",
        "certification_date": "2025-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "ACADC-90",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "28335",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "223202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fairbanks Taxi Services LLC.
• Fairbanks Ultrasound, LLC.
• Fairbanks Urology
• Fairbanks Vascular Surgery
• Fairbanks Youth Advocates (Clearwater Counseling)
• Lois Faller, BS
• Family Centered Services of Ak
• Family Centered Services of Alaska
• Family Centered Services of Alaska
• Family Centered Services of Alaska

• Clinical Social Worker in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Clinical Social Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2025; 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.