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General NPI Number Information
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NPI Number | 1275578502
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Entity Type | Organization
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Legal Business Name | NOAH'S ARC INC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3812 SEQUOIA AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-5406
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Country | US
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Telephone | 410-466-1345
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Fax | 410-466-0759
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Provider Business Mailing Address
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Address Line | 3812 SEQUOIA AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-5406
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Country | US
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Telephone | 410-466-1345
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Fax | 410-466-0759
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. SHARON BROY
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Credential | LCSW-C, BCD
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Telephone | 410-466-1345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCA043
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LCO380
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 09114
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 04058
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License Number State | MD
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