1386953768 NPI number — GINGER TREE FALCONE MA, LMFT

Table of content: GINGER TREE FALCONE MA, LMFT (NPI 1386953768)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386953768 NPI number — GINGER TREE FALCONE MA, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FALCONE
Provider First Name:
GINGER
Provider Middle Name:
TREE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KENNELL
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
LOUANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, LMFT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386953768
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/06/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1739
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAPLE FALLS
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98266-1739
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-739-8676
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7744 UPHILL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEMING
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98244-9563
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-739-8676
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/01/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: LF60142386 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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