Provider Demographics
NPI:1225833445
Name:FALLUP WELLNESS LLC
Entity type:Organization
Organization Name:FALLUP WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:GABRIELA
Authorized Official - Last Name:PEREZ BARRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC PSYA
Authorized Official - Phone:754-232-0272
Mailing Address - Street 1:6808 RADCLIFFE DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22307-1541
Mailing Address - Country:US
Mailing Address - Phone:754-232-0272
Mailing Address - Fax:
Practice Address - Street 1:1901 PENNSYLVANIA AVE NW STE 900
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-3405
Practice Address - Country:US
Practice Address - Phone:754-225-2855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-13
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty