Provider Demographics
NPI:1144806746
Name:NOLL, KATIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATIE
Middle Name:
Last Name:NOLL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 PEACHTREE ST NE STE 1901
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3574
Mailing Address - Country:US
Mailing Address - Phone:678-796-6524
Mailing Address - Fax:404-257-6975
Practice Address - Street 1:1230 PEACHTREE ST NE STE 1901
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3574
Practice Address - Country:US
Practice Address - Phone:678-796-6524
Practice Address - Fax:404-257-6975
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW007418101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health