=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346395498
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAURA KAY NOBLES MS, LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/25/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 504 DEXTER ST STE B
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27834-6320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-412-0768
-----------------------------------------------------
Fax | 252-321-2781
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3682 IVY RD
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27858-7126
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-412-0768
-----------------------------------------------------
Fax | 252-321-3781
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 4599
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------