Healthcare Provider Details

I. General information

NPI: 1417798356
Provider Name (Legal Business Name): MENTAL HEALTH COUNSELING OF STATEN ISLAND PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 VICTORY BLVD
STATEN ISLAND NY
10314-6612
US

IV. Provider business mailing address

2460 VICTORY BLVD
STATEN ISLAND NY
10314-6612
US

V. Phone/Fax

Practice location:
  • Phone: 917-781-0041
  • Fax:
Mailing address:
  • Phone: 917-781-0041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LUCIA FALCONE
Title or Position: LMHC
Credential:
Phone: 347-733-9964