Individual provider Active NPI

Elizabeth Nicole Fallon, B.S.,M.A, LPCA, NCC

  • Mental Health Counselor
  • Concord, NC
National Provider Identifier
1730608282
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A13283 Issued in NC
Practice address
280 Executive Park Dr Ste 100
Concord, NC 28025-1838
Phone
(704) 786-8220
NPI assigned
Sep 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A13283 NC Primary

Addresses

Primary practice location

280 Executive Park Dr Ste 100
Concord, NC 28025-1838

Mailing address

280 Executive Park Dr NE
Suite 100
Concord, NC 28025
Phone (704) 786-8220

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
Bachelor of Science, Master of Arts

State licenses

LicenseStateTypeSpecialty
A13283NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730608282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 EXECUTIVE PARK DR NE",
            "address_2": "SUITE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28025",
            "telephone_number": "704-786-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251838",
            "telephone_number": "704-786-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLON",
        "first_name": "ELIZABETH",
        "middle_name": "NICOLE",
        "credential": "B.S.,M.A, LPCA, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A13283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.