Provider Demographics
NPI:1134677529
Name:FALK, TAD (MS)
Entity Type:Individual
Prefix:
First Name:TAD
Middle Name:
Last Name:FALK
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 NE NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4386
Mailing Address - Country:US
Mailing Address - Phone:541-224-6762
Mailing Address - Fax:
Practice Address - Street 1:336 NE NORTON AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4386
Practice Address - Country:US
Practice Address - Phone:541-224-6762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health