Healthcare Provider Details

I. General information

NPI: 1205480399
Provider Name (Legal Business Name): JENNIFER ELIZABETH NOBLE MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2019
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 UNION AVE STE 11
BRIELLE NJ
08730-1838
US

IV. Provider business mailing address

617 UNION AVE STE 11
BRIELLE NJ
08730-1838
US

V. Phone/Fax

Practice location:
  • Phone: 732-201-8972
  • Fax:
Mailing address:
  • Phone: 732-201-8972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC00810100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: