Basic Information
| Provider Information | |||||||||
| NPI: | 1972144749 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FALCIONE | ||||||||
| FirstName: | KELLEY | ||||||||
| MiddleName: | LOUISE | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2405 CANOE DR | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153015150 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 64 S BEESON BLVD | ||||||||
| Address2: | |||||||||
| City: | UNIONTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 154013443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7243226142 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2019 | ||||||||
| LastUpdateDate: | 10/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CW020811 | PA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.