MEDICARE: NOELLE ST VIL PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1376476929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOELLE ST VIL PHD

Provider Business Mailing Address
First Line	:	92 CAPEN BLVD
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-3011
Country	:	US
Telephone Number	:	805-588-7770
Fax Number	:

Provider Business Practice Location Address
First Line	:	92 CAPEN BLVD
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-3011
Country	:	US
Telephone Number	:	805-588-7770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ NOELLE ST VIL PHD” Practice Location

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