Healthcare Provider Details

I. General information

NPI: 1962030569
Provider Name (Legal Business Name): NOAH DOBBE LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2528 RIDGE RUNNER RD
LAS VEGAS NM
87701-4971
US

IV. Provider business mailing address

1635 CABO LUCERO RD
LAS VEGAS NM
87701-9716
US

V. Phone/Fax

Practice location:
  • Phone: 806-418-1934
  • Fax:
Mailing address:
  • Phone: 806-418-1934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCMH0203781
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: