Provider Demographics
NPI:1134740806
Name:FALLIN, CLAIRE BAUERLEIN (LPC)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:BAUERLEIN
Last Name:FALLIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:KATHLEEN
Other - Last Name:BAUERLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:13117 BROOK ARBOR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4823
Mailing Address - Country:US
Mailing Address - Phone:210-313-3286
Mailing Address - Fax:
Practice Address - Street 1:13117 BROOK ARBOR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4823
Practice Address - Country:US
Practice Address - Phone:210-313-3286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80707101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional