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Organization

BEACON BEHAVIORAL HEALTH, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RONDA O FALK MSW, LCSW (MEMBER MANAGER)
(919) 880-7613
Entity
Organization

Contact information

Practice address
3207 ROGERS RD, SUITE 204, WAKE FOREST, NC 27587-3834
(919) 880-7613
(919) 366-9705
Mailing address
PO BOX 370, ROLESVILLE, NC 27571-0370
(919) 880-7613
(919) 366-9705

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004632
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
136FC
BCBSNC
NC
05
6002797
NC
Enumeration date
07/18/2006
Last updated
08/22/2020
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