Provider Demographics
NPI:1790493484
Name:FALL, ROKHAYA (LCSW)
Entity Type:Individual
Prefix:
First Name:ROKHAYA
Middle Name:
Last Name:FALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5057 COBBLESTONE RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-9618
Mailing Address - Country:US
Mailing Address - Phone:404-493-8865
Mailing Address - Fax:
Practice Address - Street 1:MARKTSTRASSE 65
Practice Address - Street 2:
Practice Address - City:BONN
Practice Address - State:GERMANY
Practice Address - Zip Code:53229
Practice Address - Country:DE
Practice Address - Phone:404-493-8865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0078231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical