Healthcare Provider Details

I. General information

NPI: 1821911140
Provider Name (Legal Business Name): NOIRE PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 EAST JACKSON BLVD APT 201
ELKART IN
46516
US

IV. Provider business mailing address

402 EAST JACKSON BLVD APT 201
ELKART IN
46516
US

V. Phone/Fax

Practice location:
  • Phone: 574-213-2675
  • Fax: 773-669-3991
Mailing address:
  • Phone: 574-213-2675
  • Fax: 773-669-3991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ONYINYECHUKWU JUDITH AMOBI
Title or Position: OWNER
Credential: NP
Phone: 574-213-2675