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General NPI Number Information
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NPI Number | 1710614458
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Entity Type | Individual
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Provider Name | NOAH ATLAS
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Gender | Male
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Dates
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Enumeration Date | 08/03/2022
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Last Update Date | 08/03/2022
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Provider Practice Location Address
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Address Line | 135 GOLD STAR BLVD
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City | WORCESTER
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State | MA
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Zip | 01606-2738
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Country | US
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Telephone | 508-755-2340
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Fax |
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Provider Business Mailing Address
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Address Line | 53 SYKES AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1316
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Country | US
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Telephone | 973-216-2338
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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