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General NPI Number Information
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NPI Number | 1255995437
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Entity Type | Individual
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Provider Name | BRADFORD NOBLE MS, LPCC
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Gender | Male
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Dates
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Enumeration Date | 04/23/2019
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 7741 LOOKOUT DR
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City | LA JOLLA
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State | CA
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Zip | 92037-3949
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Country | US
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Telephone | 212-543-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 7741 LOOKOUT DR
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City | LA JOLLA
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State | CA
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Zip | 92037-3949
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Country | US
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Telephone | 212-543-0111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 21314
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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