Provider Demographics
NPI:1003868613
Name:NOBLE, JAMES A (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:NOBLE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:ANTHONY
Other - Last Name:NOBLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:11 W VICTORY WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2605
Mailing Address - Country:US
Mailing Address - Phone:970-629-3826
Mailing Address - Fax:970-824-5555
Practice Address - Street 1:439 BREEZE ST STE 200
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2646
Practice Address - Country:US
Practice Address - Phone:970-824-6541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9919311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS070394Medicare ID - Type Unspecified