Provider Demographics
NPI:1356923460
Name:FAULCON, JASMINE RENEE (LCMHC)
Entity type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:RENEE
Last Name:FAULCON
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:RENEE
Other - Last Name:FAULCON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCMHC
Mailing Address - Street 1:1240 HUFFMAN MILL RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8700
Mailing Address - Country:US
Mailing Address - Phone:335-538-7893
Mailing Address - Fax:
Practice Address - Street 1:1240 HUFFMAN MILL RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8700
Practice Address - Country:US
Practice Address - Phone:336-538-7893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-27163101YA0400X
NC16621101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)