MEDICARE: KASSIDY NOBLE

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	101Y00000X	Counselor		OH

General Provider Information

NPI Number	:	1649104381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KASSIDY NOBLE

Provider Business Mailing Address
First Line	:	16 W LONG ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-2815
Country	:	US
Telephone Number	:	614-225-0990
Fax Number	:	614-225-0991

Provider Business Practice Location Address
First Line	:	950 MEADOW DR STE A
Second Line	:
City	:	MOUNT GILEAD
State	:	OH
Zip	:	43338-1389
Country	:	US
Telephone Number	:	419-949-2000
Fax Number	:	419-751-7322

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

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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Directions to “ KASSIDY NOBLE ” Practice Location

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