Provider Demographics
NPI:1285660167
Name:FALZON, JEAN (MA,CAC,LPC)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:FALZON
Suffix:
Gender:F
Credentials:MA,CAC,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 2340
Mailing Address - Street 2:
Mailing Address - City:CANADENSIS
Mailing Address - State:PA
Mailing Address - Zip Code:18325-9710
Mailing Address - Country:US
Mailing Address - Phone:570-595-6055
Mailing Address - Fax:570-595-6013
Practice Address - Street 1:RR 2 BOX 2340
Practice Address - Street 2:
Practice Address - City:CANADENSIS
Practice Address - State:PA
Practice Address - Zip Code:18325
Practice Address - Country:US
Practice Address - Phone:570-595-6055
Practice Address - Fax:570-595-6055
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC 002248101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional