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NPI Code Detail

MEDICARE: GWENDOLYNNE NOONAN LCSW

MEDICARE: GWENDOLYNNE NOONAN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerC017925NC
21041C0700XClinical Social Worker115475TX

General Provider Information

NPI Number : 1346987823
Entity Type Code : Individual
Provider Name (Legal Business Name) : GWENDOLYNNE NOONAN LCSW
Provider Business Mailing Address
First Line : 1318 CIRCLE DR
Second Line :
City : ABILENE
State : TX
Zip : 79602-5304
Country : US
Telephone Number : 303-550-9491
Fax Number :
Provider Business Practice Location Address
First Line : 711 ROANOKE AVE
Second Line :
City : ELIZABETH CITY
State : NC
Zip : 27909-5643
Country : US
Telephone Number : 252-338-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2022
Last Update Date : 06/09/2026

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Directions to “ GWENDOLYNNE NOONAN LCSW” Practice Location

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