Provider Demographics
NPI:1174259501
Name:FLEMING, NOEL LOUISE (TLLP)
Entity Type:Individual
Prefix:MS
First Name:NOEL
Middle Name:LOUISE
Last Name:FLEMING
Suffix:
Gender:F
Credentials:TLLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 E LAKE ST STE 7
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2459
Mailing Address - Country:US
Mailing Address - Phone:616-617-1907
Mailing Address - Fax:
Practice Address - Street 1:321 E LAKE ST STE 7
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2459
Practice Address - Country:US
Practice Address - Phone:231-622-5460
Practice Address - Fax:231-344-6003
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6362009554103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling