Provider Demographics
NPI:1164431276
Name:NOELTING, DALE CARLON (PHD)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:CARLON
Last Name:NOELTING
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 OHIO RIVER BLVD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1300
Mailing Address - Country:US
Mailing Address - Phone:412-741-2005
Mailing Address - Fax:412-741-4988
Practice Address - Street 1:301 OHIO RIVER BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1300
Practice Address - Country:US
Practice Address - Phone:412-741-2005
Practice Address - Fax:412-741-4988
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006447L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS34838Medicare UPIN