MEDICARE: ELIZABETH A FALLEN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	10320	TN
2	1041C0700X	Clinical Social Worker	34004360A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	839090JJJ	OTHER	IN	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000281550	OTHER	IN	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	11489580	OTHER		CAQH

General Provider Information

NPI Number	:	1538170014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH A FALLEN LCSW

Provider Business Mailing Address
First Line	:	4800 N SCOTTSDALE RD STE 2500
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7630
Country	:	US
Telephone Number	:	216-468-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	7300 E INDIANA ST STE 103
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-7448
Country	:	US
Telephone Number	:	216-468-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	05/11/2026

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Directions to “ ELIZABETH A FALLEN LCSW” Practice Location

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