Individual
MR. WADE M FALCONBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, MAC, PACT
Contact information
Practice address
PO BOX 61416, FAIRBANKS, AK 99706-1416
(208) 577-1015
Mailing address
PO BOX 61416, FAIRBANKS, AK 99706-1416
(208) 577-1015
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACADC-90
ID
1041C0700X
Clinical Social Worker
Primary
223202
AK
1041C0700X
Clinical Social Worker
28335
ID
Other
Enumeration date
07/13/2007
Last updated
01/01/2025
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