Healthcare Provider Details

I. General information

NPI: 1033742416
Provider Name (Legal Business Name): BETH LIANE NOEL LMHC, LCAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2020
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 LEGACY PLZ W
LA PORTE IN
46350-5254
US

IV. Provider business mailing address

6050 STERLING CREEK RD
PORTAGE IN
46368-7752
US

V. Phone/Fax

Practice location:
  • Phone: 219-763-8112
  • Fax:
Mailing address:
  • Phone: 219-763-8112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number87001698A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39004361A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: