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General NPI Number Information
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NPI Number | 1508212812
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Entity Type | Individual
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Provider Name | PETER MOISES FALCON LPCC
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Gender | Male
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 9245 QUANTRELLE AVE NE
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City | OTSEGO
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State | MN
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Zip | 55330-0168
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Country | US
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Telephone | 763-746-9492
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Fax | 763-746-3685
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Provider Business Mailing Address
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Address Line | 1900 SILVER LAKE RD NW STE 110
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City | NEW BRIGHTON
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State | MN
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Zip | 55112-1789
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Country | US
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Telephone | 651-628-9566
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Fax | 651-628-0411
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2052
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10678
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2052
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License Number State | MN
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