Nicole Fallon, LCSW
Individual provider Active NPI Clinical Social Worker · Tivoli, NY
NPI 1922567882 · NPPES record last updated Mar 27, 2024
Key facts
- NPI
- 1922567882
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 096275 (NY)
- Practice address
- 176 Nevis Rd
Tivoli, NY 12583-5009 - Phone
- (518) 217-5551
- NPI assigned
- Mar 19, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103246 | NY | MD | Social Worker |
| 096275 | NY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 103246 | NY | |
| Clinical Social Worker | 1041C0700X | 096275 | NY | Yes |
Addresses
Primary practice location
176 Nevis Rd
Tivoli, NY 12583-5009
Mailing address
176 Nevis Rd
Tivoli, NY 12583-5009
Phone (845) 416-4015
Other practice location 1
1068 Main St Ste 201
Fishkill, NY 12524-3659
Phone (845) 202-2285
Other names
- Nicole Carney
Other providers in Tivoli, NY
- Melissa Bell-Dentico
- Robin Marie Boice
- Katherine Anne Collins
- Patrick James Dentico
- Sara Dragula
- Meredith Claire Goff
- Roberta Lynn Hayes
- Christopher J Karpinski
- Heidi A Kronenberg
- Bernadette Mary McCrudden
All providers in Tivoli, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.