Provider Demographics
NPI:1689905028
Name:FALLON, FRANCES ARLENE (MFT,LADC)
Entity Type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:ARLENE
Last Name:FALLON
Suffix:
Gender:F
Credentials:MFT,LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 BURBAN DR
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-4003
Mailing Address - Country:US
Mailing Address - Phone:475-434-8001
Mailing Address - Fax:
Practice Address - Street 1:929 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-4220
Practice Address - Country:US
Practice Address - Phone:860-436-6318
Practice Address - Fax:860-436-6318
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000778101YA0400X
CT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist