| Doctor Name: | BRIAN KEITH FALCK |
| NPI Number: | 1134423445 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 1996-123 |
| Business Practice Address: | N8809 Bus Hwy 13 Westboro, WI - 544909444 |
| Business Phone Number: | 9204757668 |
| Business Fax Number: | |
| Mailing Address: | N8809 Bus Hwy 13, WESTBORO |
| State: | WI |
| Postal Code: | 544909444 |
| Phone Number: | 9204757668 |
| Fax Number: | |
| NPI Enumeration Date: | 12/29/2010 |
| NPI Last Update Date: | 08/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 1996-123 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |