Provider Demographics
NPI:1609234889
Name:FALCON, BRANDY
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:FALCON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59335 RIVER WEST DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-6553
Mailing Address - Country:US
Mailing Address - Phone:225-385-4543
Mailing Address - Fax:866-825-9703
Practice Address - Street 1:59335 RIVER WEST DR
Practice Address - Street 2:SUITE B
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-6553
Practice Address - Country:US
Practice Address - Phone:225-385-4543
Practice Address - Fax:866-825-9703
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health