Healthcare Provider Details

I. General information

NPI: 1588420905
Provider Name (Legal Business Name): VICTORIA ANNE FALLON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 MAGUIRE RD STE 2002
OCOEE FL
34761-4742
US

IV. Provider business mailing address

2910 MAGUIRE RD STE 2002
OCOEE FL
34761-4742
US

V. Phone/Fax

Practice location:
  • Phone: 407-287-1664
  • Fax:
Mailing address:
  • Phone: 407-287-1664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC016816
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27057
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: