Individual provider Active NPI

Joseph Henry Fallon Jr., PH.D.

  • Group Psychotherapy Psychologist
  • Lawrenceville, GA
National Provider Identifier
1285789222
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
License
PSY001056 Issued in GA
Practice address
1805 Herrington Rd
BLDG 2
Lawrenceville, GA 30043-5649
Phone
(770) 962-1944
Fax
(770) 962-1886
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY001056 GA
Health Service Psychologist 103TH0100X PSY001056 GA
Psychologist 103T00000X PSY001056 GA
Group Psychotherapy Psychologist 103TP2701X PSY001056 GA Primary

Addresses

Primary practice location

1805 Herrington Rd
BLDG 2
Lawrenceville, GA 30043-5649

Mailing address

1805 Herrington Rd
BLDG 2
Lawrenceville, GA 30043-5649
Phone (770) 962-1944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20050712000785 GA Practitioner - Clinical Psychologist 3072549955 Practice locations: Atlanta, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2271 Shasta Way NE
Atlanta, GA 30345-2603
Phone 770785270414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY001056GAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1285789222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 HERRINGTON RD",
            "address_2": "BLDG 2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435649",
            "telephone_number": "770-962-1944",
            "fax_number": "770-962-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HERRINGTON RD",
            "address_2": "BLDG 2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435649",
            "telephone_number": "770-962-1944",
            "fax_number": "770-962-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLON",
        "first_name": "JOSEPH",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY001056",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "GA",
            "license": "PSY001056",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY001056",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "GA",
            "license": "PSY001056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.