Provider Demographics
NPI:1225556871
Name:CARNES, FALLON MICHELLE (MSW, CSW)
Entity Type:Individual
Prefix:MS
First Name:FALLON
Middle Name:MICHELLE
Last Name:CARNES
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 BELINDA BLVD.
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422
Mailing Address - Country:US
Mailing Address - Phone:859-209-2320
Mailing Address - Fax:859-209-4278
Practice Address - Street 1:106 BELINDA BLVD.
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422
Practice Address - Country:US
Practice Address - Phone:859-209-2320
Practice Address - Fax:859-209-4278
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2562261041C0700X
KY253109101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)