Provider Demographics
NPI: | 1639921091 |
---|---|
Name: | FALLON THERAPY AND BUSINESS SOLUTIONS |
Entity Type: | Organization |
Organization Name: | FALLON THERAPY AND BUSINESS SOLUTIONS |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/OPERATOR/CLINICAL DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CASSANDRA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FALLON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LMFT |
Authorized Official - Phone: | 614-204-8121 |
Mailing Address - Street 1: | 107 N UNION BLVD |
Mailing Address - Street 2: | |
Mailing Address - City: | COLORADO SPRINGS |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80909-5703 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 719-445-9968 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 107 N UNION BLVD |
Practice Address - Street 2: | |
Practice Address - City: | COLORADO SPRINGS |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80909-5703 |
Practice Address - Country: | US |
Practice Address - Phone: | 719-445-9968 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-04-01 |
Last Update Date: | 2024-04-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty |