Active NPI
Kathleen McCann Fallon, PH.D.
- Mental Health Counselor
- Santa Fe, NM
National Provider Identifier
1114305174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0169931
- Practice address
- 3 Caliente Rd
Suite 6
Santa Fe, NM 87508-9209 - Phone
- (505) 930-5001
- NPI assigned
- May 11, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0169931 | NM | Primary |
Addresses
Primary practice location
3 Caliente Rd
Suite 6
Santa Fe, NM 87508-9209
Mailing address
3 Caliente Rd
Suite 6
Santa Fe, NM 87508-9209
Phone (505) 930-5001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0169931 | NM | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Gloaming, LLC | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431302400000",
"number": "1114305174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 CALIENTE RD",
"address_2": "SUITE 6",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875089209",
"telephone_number": "505-930-5001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 CALIENTE RD",
"address_2": "SUITE 6",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875089209",
"telephone_number": "505-930-5001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALLON",
"first_name": "KATHLEEN",
"middle_name": "MCCANN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-11",
"last_updated": "2015-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "0169931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.