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General NPI Number Information
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NPI Number | 1710801329
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Entity Type | Individual
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Provider Name | HEATHER ANNELISE NOULIS LPC-MHSP, MPA
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Gender | Female
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 3322 S ELLSWORTH RD
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City | MESA
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State | AZ
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Zip | 85212-2730
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Country | US
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Telephone | 480-780-0211
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Fax |
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Provider Business Mailing Address
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Address Line | 9722 S 45TH AVE
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City | LAVEEN
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State | AZ
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Zip | 85339-2099
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Country | US
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Telephone | 631-745-4618
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5995
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-24276
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License Number State | AZ
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