Healthcare Provider Details

I. General information

NPI: 1578538922
Provider Name (Legal Business Name): THOMAS KEARNEY NOBLES L.C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 09/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70A GREENWICH AVE SUITE 260
NEW YORK NY
10011-8300
US

IV. Provider business mailing address

70A GREENWICH AVE SUITE 260
NEW YORK NY
10011-8300
US

V. Phone/Fax

Practice location:
  • Phone: 646-734-9304
  • Fax:
Mailing address:
  • Phone: 646-734-9304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number072131-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: