Provider Demographics
NPI:1174813331
Name:FALLON, APRIL ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:ELIZABETH
Last Name:FALLON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2557 GADSEN WALK
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-4349
Mailing Address - Country:US
Mailing Address - Phone:404-403-2701
Mailing Address - Fax:770-813-9001
Practice Address - Street 1:2557 GADSEN WALK
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4349
Practice Address - Country:US
Practice Address - Phone:404-403-2701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0040651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical