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General NPI Number Information
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NPI Number | 1417609017
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Entity Type | Individual
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Provider Name | JESSICA NOESEN MA, LCPC
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Gender | Female
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 405 BILLS LN APT D211
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City | COLUMBIA FALLS
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State | MT
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Zip | 59912-3963
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Country | US
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Telephone | 714-418-3844
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Fax |
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Provider Business Mailing Address
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Address Line | 405 BILLS LN APT D211
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City | COLUMBIA FALLS
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State | MT
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Zip | 59912-3963
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Country | US
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Telephone | 714-418-3844
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 178016895
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 36744
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | BBH-LCPC-LIC-72320
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License Number State | MT
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