Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Keith James Fallon, PSYD

Individual provider Psychologist · NPI 1770635401

Dr. Keith James Fallon, PSYD is a Clinical Psychologist in Conyers, Georgia. Qualified in 2001, 25 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
25
Licensed in
GA
In the registry since
2007
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

1100 Green St SW
Conyers, GA 30012-5220
Phone: (404) 502-5824
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence PSY002856 (GA)

Record details

NPI number1770635401
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorNo
NPI enumeratedJanuary 16, 2007
Last updated in NPPESJanuary 21, 2015
Mailing addressPo Box 1790, Conyers, GA 30012-7964

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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