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NPI Code Detail

MEDICARE: FALON AMELIA ROBERSON LMSW, BCBA, LBA

MEDICARE: FALON AMELIA ROBERSON LMSW, BCBA, LBA
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
11041S0200XSchool Social Worker000626130TN
2103K00000XBehavior Analyst1-16-24900TN
3103K00000XBehavior Analyst200010MS
4103K00000XBehavior Analyst330TN
5104100000XSocial Worker10650TN

General Provider Information

NPI Number : 1568814317
Entity Type Code : Individual
Provider Name (Legal Business Name) : FALON AMELIA ROBERSON LMSW, BCBA, LBA
Provider Business Mailing Address
First Line : 3184 GLADE VERDE LN
Second Line :
City : LAKELAND
State : TN
Zip : 38002-4165
Country : US
Telephone Number : 901-517-2160
Fax Number :
Provider Business Practice Location Address
First Line : 5170 SANDERLIN AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38117-4360
Country : US
Telephone Number : 901-517-2160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2016
Last Update Date : 06/08/2026

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