Kayla Marie Fallen
Individual provider Active NPI Mental Health Counselor · Peru, IL
NPI 1073294997 · NPPES record last updated Apr 17, 2024
Key facts
- NPI
- 1073294997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 710 Peoria St
Peru, IL 61354-3351 - Phone
- (815) 780-0690
- Fax
- (815) 410-1937
- NPI assigned
- Jul 25, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
710 Peoria St
Peru, IL 61354-3351
Mailing address
710 Peoria St
Peru, IL 61354-3351
Phone (815) 780-0690
Other providers in Peru, IL
- Rachel Marie Edgcomb
- Emerging Vision, Inc
- Andrea Erickson
- Eugene Becker MD SC
- Eye Care Professionals of Peru OD PC
- Family Foot Care PC
- Brenden Fasken
- Mark Allen Fernandez
- Kassi Ann Filipiak
- Gailey Eye Clinic, LTD
All providers in Peru, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.