Provider Demographics
NPI:1396623732
Name:FALCON, JAILEY ZAYDEN
Entity type:Individual
Prefix:
First Name:JAILEY
Middle Name:ZAYDEN
Last Name:FALCON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10080 BIA ROAD 5
Mailing Address - Street 2:
Mailing Address - City:BELCOURT
Mailing Address - State:ND
Mailing Address - Zip Code:58316-3804
Mailing Address - Country:US
Mailing Address - Phone:701-472-2107
Mailing Address - Fax:701-472-2107
Practice Address - Street 1:10080 BIA ROAD 5
Practice Address - Street 2:
Practice Address - City:BELCOURT
Practice Address - State:ND
Practice Address - Zip Code:58316-3804
Practice Address - Country:US
Practice Address - Phone:701-472-2107
Practice Address - Fax:701-472-2107
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical