Healthcare Provider Details

I. General information

NPI: 1689189995
Provider Name (Legal Business Name): MRS. NOELLE DARNOLD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NOELLE BENNETT

II. Dates (important events)

Enumeration Date: 12/08/2017
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 N MAIN ST
ROCHELLE IL
61068-1686
US

IV. Provider business mailing address

952 ARVLE CIR
SYCAMORE IL
60178-9517
US

V. Phone/Fax

Practice location:
  • Phone: 815-501-2088
  • Fax:
Mailing address:
  • Phone: 815-914-1886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number18001405
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: