Fallon Clayton I – Mental Health Counselor

Key facts

NPI: 1811348451
Entity type: Individual (NPI type 1)
Primary specialty: Mental Health Counselor 101YM0800X
Practice address: 101 Oliver St
Vienna, IL 62995-1660
Phone: (618) 658-2611
NPI assigned: Jun 24, 2016
Sex: Female
Sole proprietor: No

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 and National Provider Directory roles.

Arrowleaf Mental Health Clinic/Center (Including Community Mental Health Center) · Golconda, IL · NPI 1538114608

NPD (past)
Arrowleaf Mental Health Clinic/Center (Including Community Mental Health Center) · Vienna, IL · NPI 1598912263

NPD (past) MENTAL HEALTH

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Arrowleaf		Past since Jul 1, 2018	Accepting new patients
Arrowleaf	Mental Health	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mental Health Counselor	101YM0800X			Yes

Addresses

Primary practice location

101 Oliver St
Vienna, IL 62995-1660

Mailing address

2560 Friendship School Rd
Anna, IL 62906-3560
Phone (618) 697-4443

Other providers in Vienna, IL

All providers in Vienna, IL · Mental Health Counselor in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.