Provider Demographics
NPI:1740438209
Name:FALKMAN, CRAIG DEAN (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:DEAN
Last Name:FALKMAN
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1957
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82717-1957
Mailing Address - Country:US
Mailing Address - Phone:307-686-4062
Mailing Address - Fax:307-686-8109
Practice Address - Street 1:400 S KENDRICK AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3848
Practice Address - Country:US
Practice Address - Phone:307-686-4062
Practice Address - Fax:307-686-8109
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC952101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health