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NPI Code Detail

MEDICARE: MS. ALICE WADE NOLES LCSW

MEDICARE: MS. ALICE WADE NOLES LCSW
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
11041C0700XClinical Social Worker41966TX

General Provider Information

NPI Number : 1700282068
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ALICE WADE NOLES LCSW
Provider Business Mailing Address
First Line : 9004 COUNTY ROAD 1128
Second Line :
City : GODLEY
State : TX
Zip : 76044-3407
Country : US
Telephone Number : 817-229-7486
Fax Number :
Provider Business Practice Location Address
First Line : 1300 S UNIVERSITY DR STE 306
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-5746
Country : US
Telephone Number : 844-824-8775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2014
Last Update Date : 01/09/2023

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