Provider Demographics
NPI:1568822161
Name:FALLON, REBECCA DAWN (MS, LCPC, LAC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:DAWN
Last Name:FALLON
Suffix:
Gender:F
Credentials:MS, LCPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 GRAND AVE STE 122
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2763
Mailing Address - Country:US
Mailing Address - Phone:406-871-2530
Mailing Address - Fax:
Practice Address - Street 1:1925 GRAND AVE STE 122
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2763
Practice Address - Country:US
Practice Address - Phone:406-871-2530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-16215101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health