Individual provider Active NPI

Mardi Kay Fallon, LPCC-S

  • Mental Health Counselor
  • Fairfield, OH
National Provider Identifier
1255535092
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.8254-S Issued in OH
Practice address
1251 Nilles Rd Ste 5
Fairfield, OH 45014-7205
Phone
(513) 939-0300
Fax
(513) 939-0310
NPI assigned
Jun 14, 2007
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E.8254-S OH Primary
Social Worker 104100000X S13653 OH

Addresses

Primary practice location

1251 Nilles Rd Ste 5
Fairfield, OH 45014-7205

Mailing address

1251 Nilles Rd Ste 5
Fairfield, OH 45014-7205
Phone (513) 939-0300

Other practice location 1

502 Farrell Dr
Covington, KY 41011-3717
Phone (859) 578-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250806003771 KY Practitioner - Mental Health Counselor 3577071869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

502 Farrell Dr
Covington, KY 41011-3717
Phone (859) 578-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.8254-SOHMDMental Health Counselor
S13653OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Kentucky Mental Health Mental Retardation Regional Board CurrentSince Jun 23, 2025 Accepting new patients
Northern Kentucky Mental Health Mental Retardation Regional Board CurrentSince Jun 23, 2025 Accepting new patients

Locations

502 Farrell Dr
Covington, KY 41011
Phone (859) 578-3204

503 Farrell Dr
Covington, KY 41011
Phone (606) 578-3214

513 Madison Ave
Fl 1
Covington, KY 41011

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1255535092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 NILLES RD STE 5",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450147205",
            "telephone_number": "513-939-0300",
            "fax_number": "513-939-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 NILLES RD STE 5",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450147205",
            "telephone_number": "513-939-0300",
            "fax_number": "513-939-0310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 Farrell Dr",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "KY",
            "postal_code": "410113717",
            "country_code": "US",
            "telephone_number": "859-578-3200",
            "fax_number": "859-534-2627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FALLON",
        "first_name": "MARDI",
        "middle_name": "KAY",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.8254-S",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S13653",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.