Healthcare Provider Details

I. General information

NPI: 1518108752
Provider Name (Legal Business Name): CHRISTINA LYNNE NOBLE PH.D., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 01/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 POWERS FERRY RD SE BUILDING 9, SUITE 100
MARIETTA GA
30067-5491
US

IV. Provider business mailing address

1640 POWERS FERRY RD SE BUILDING 9, SUITE 100
MARIETTA GA
30067-5491
US

V. Phone/Fax

Practice location:
  • Phone: 770-953-0080
  • Fax: 770-953-0031
Mailing address:
  • Phone: 770-953-0080
  • Fax: 770-953-0031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC006328
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY003763
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: