Provider Demographics
NPI:1073080529
Name:NOBLITT, VANESSA R (LPC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:R
Last Name:NOBLITT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 N 6TH ST STE 315
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-6046
Mailing Address - Country:US
Mailing Address - Phone:208-717-5756
Mailing Address - Fax:208-473-7307
Practice Address - Street 1:223 N 6TH ST STE 315
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-6046
Practice Address - Country:US
Practice Address - Phone:208-717-5756
Practice Address - Fax:208-473-7307
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-6922101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health