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General NPI Number Information
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NPI Number | 1407402407
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Entity Type | Individual
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Provider Name | NOAH CREMEANS QMHS 3YRS CMS
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Gender | Male
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Dates
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Enumeration Date | 08/15/2019
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 1199 DELAWARE AVE STE 107
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City | MARION
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State | OH
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Zip | 43302-7462
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Country | US
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Telephone | 440-260-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 45 TROTTERS CIR
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City | DELAWARE
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State | OH
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Zip | 43015-3362
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Country | US
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Telephone | 740-971-3029
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2507009
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License Number State | OH
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