Kathleen Coulborn Faller, MSW, PHD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

061768 Issued in MI

Practice address

555 S Forest Ave
Ann Arbor, MI 48104-2584

Phone

(734) 998-9700

Fax

(734) 998-9710

NPI assigned

Jun 26, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Family Assessment Clinic

  • Mental Health Counselor
  • Ann Arbor, MI
  • NPI 1023384070
  NPD (past) Authorized official

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1588928329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S FOREST AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042584",
            "telephone_number": "734-998-9700",
            "fax_number": "734-998-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S FOREST AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042584",
            "telephone_number": "734-998-9700",
            "fax_number": "734-998-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLER",
        "first_name": "KATHLEEN",
        "middle_name": "COULBORN",
        "name_prefix": "Dr.",
        "credential": "MSW, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "061768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Ann Falasa, CRNA
• Eduardo Falco Knaut, MD
• Harvey H Falit, M.D.
• Eli Falk
• David Vernon Falkner, PHD
• Laura Sineni Falzon I
• Family Assessment Clinic
• Family Assessment Clinic
• Family Chiropractic Clinics of Michigan, P.C.
• Family Medical Center of Michigan,Inc

• Clinical Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.