Healthcare Provider Details

I. General information

NPI: 1063870186
Provider Name (Legal Business Name): STEPHEN FALCONIERI LPC,LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 WASHINGTON AVE STE 2
NORTH HAVEN CT
06473-1123
US

IV. Provider business mailing address

605 WASHINGTON AVE STE 2
NORTH HAVEN CT
06473-1123
US

V. Phone/Fax

Practice location:
  • Phone: 203-228-2606
  • Fax:
Mailing address:
  • Phone: 203-228-2606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1279
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-3740
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: