MEDICARE: CASSANDRA FALLON LMFT

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	106H00000X	Marriage & Family Therapist	00001238	CO

General Provider Information

NPI Number	:	1578922506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA FALLON LMFT

Provider Business Mailing Address
First Line	:	3387 APOGEE VW
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4047
Country	:	US
Telephone Number	:	719-445-9968
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 N UNION BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-5703
Country	:	US
Telephone Number	:	719-445-9968
Fax Number	:

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

Provider Enumeration Date	:	02/18/2016
Last Update Date	:	04/01/2024

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