| Keith Fallon, Psy.d., P.c. | |
|
1100 Green St Sw Conyers GA 30012-5220 | |
| (404) 502-5824 | |
| Not Available |
| Full Name | Keith Fallon, Psy.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 1100 Green St Sw, Conyers, Georgia |
| Authorized Official Name and Position | Keith James Fallon (CEO) |
| Authorized Official Contact | 4045025824 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Fallon, Psy.d., P.c. Po Box 1790 Conyers GA 30012-7964 Ph: (404) 502-5824 | Keith Fallon, Psy.d., P.c. 1100 Green St Sw Conyers GA 30012-5220 Ph: (404) 502-5824 |
| NPI Number | 1801947569 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6800100702 |
|---|---|
| Medicare Enrollment ID | O20150806009886 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801947569 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY002856 (Georgia) | Primary |
| Provider Name | Keith James Fallon |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1770635401 PECOS PAC ID: 7618281510 Enrollment ID: I20150806009919 |
Family 360 Incorporated Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 Exchange Pl Se Ste A, Conyers, GA 30013 Phone: 770-679-0586 Fax: 770-554-9349 | |
Douglas Counseling, Coaching, & Consulting, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1665 Village Place Cir Ne, Conyers, GA 30012 Phone: 706-519-3030 | |
Academy For Family Empowerment Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1015 Milstead Ave Ne, #210, Conyers, GA 30012 Phone: 770-918-8003 Fax: 770-918-8800 | |
Raven Counseling Services, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 867 Commerce Dr Sw, Suite 200-400, Conyers, GA 30094 Phone: 770-679-4043 Fax: 770-679-4915 | |
Keys To A Healthy Relationship,llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 997 Commerce Dr Sw, Suite3e, Conyers, GA 30094 Phone: 404-664-0881 Fax: 800-449-1093 | |
Hope And Grace Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 997 Commerce Dr Sw, Ste 3a, Conyers, GA 30094 Phone: 678-561-7476 | |
Graceol Counseling Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1035 Honey Creek Rd Se, Conyers, GA 30013 Phone: 404-839-2688 Fax: 770-922-9498 |