Erin Fallath, MA, LPCC, LICDC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.1901031 Issued in OH

Practice address

6406 Thornberry CT Ste 220B
Mason, OH 45040

Phone

(513) 445-9959

Fax

(513) 725-1276

NPI assigned

Dec 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Erin Fortner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Journey Well, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mason, OH
  • NPI 1134577349
  NPD (past)

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1336683986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6406 THORNBERRY CT STE 220B",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450407880",
            "telephone_number": "513-445-9959",
            "fax_number": "513-725-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6406 THORNBERRY CT STE 220B",
            "city": "MASON",
            "state": "OH",
            "postal_code": "45040",
            "telephone_number": "513-445-9959",
            "fax_number": "513-725-1276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6406 Thornberry Ct Ste 220B",
            "address_purpose": "LOCATION",
            "city": "Mason",
            "state": "OH",
            "postal_code": "45040",
            "country_code": "US",
            "telephone_number": "513-445-9959",
            "fax_number": "513-725-1276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FALLATH",
        "first_name": "ERIN",
        "credential": "MA, LPCC, LICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161709",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1901031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "FORTNER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Mason, OH
• Providers in Mason, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.