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General NPI Number Information
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NPI Number | 1487218251
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Entity Type | Organization
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Legal Business Name | NOBLES COUNSELING GROUP, LLC
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Dates
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Enumeration Date | 04/27/2019
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Last Update Date | 04/27/2019
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Provider Practice Location Address
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Address Line | 1713 BROADMOOR DR STE 301
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City | BRYAN
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State | TX
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Zip | 77802-5220
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Country | US
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Telephone | 936-463-8120
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Fax | 979-383-2199
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Provider Business Mailing Address
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Address Line | 1713 BROADMOOR DR STE 301
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City | BRYAN
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State | TX
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Zip | 77802-5220
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Country | US
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Telephone | 936-463-8120
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JUSTIN SCOTT NOBLES
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Credential | LPC, LCDC
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Telephone | 936-463-8120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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