Provider Demographics
NPI:1104887512
Name:FALLS, GERALD F (PHD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:F
Last Name:FALLS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1922 WILLOW RUN DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-3732
Mailing Address - Country:US
Mailing Address - Phone:850-443-5936
Mailing Address - Fax:
Practice Address - Street 1:1922 WILLOW RUN DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-3732
Practice Address - Country:US
Practice Address - Phone:850-443-5936
Practice Address - Fax:850-893-4387
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY001085103TC0700X
AL588103TC0700X
FLPY0003703103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA021186OtherTRICARE
GA52428441001OtherBLUECROSS BLUESHIELD-GA
GA217945784OtherUNITED BEHAVIORAL HEALTH
GA00450755AMedicaid
GA021186OtherVALUEOPTIONS
GA00450755AMedicaid
GA021186OtherVALUEOPTIONS