Provider Demographics
NPI:1659965275
Name:FALCK, MEL (LCMHCA)
Entity Type:Individual
Prefix:MR
First Name:MEL
Middle Name:
Last Name:FALCK
Suffix:
Gender:M
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 MOONFISH LN
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-7845
Mailing Address - Country:US
Mailing Address - Phone:304-374-8329
Mailing Address - Fax:
Practice Address - Street 1:1760 HIGHWAY 105
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-7808
Practice Address - Country:US
Practice Address - Phone:828-414-1227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11556101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty