Provider Demographics
NPI:1730272014
Name:FALLER, MARIAN MCCASLIN (LICSW)
Entity type:Individual
Prefix:MS
First Name:MARIAN
Middle Name:MCCASLIN
Last Name:FALLER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HILLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-1313
Mailing Address - Country:US
Mailing Address - Phone:401-596-8800
Mailing Address - Fax:401-315-8831
Practice Address - Street 1:10 HILLVIEW DR
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-1313
Practice Address - Country:US
Practice Address - Phone:401-596-8800
Practice Address - Fax:401-315-8831
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW015301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical