Provider Demographics
NPI:1174825277
Name:NOE, NEALY EVE (MA, MFTI #64906)
Entity Type:Individual
Prefix:MS
First Name:NEALY
Middle Name:EVE
Last Name:NOE
Suffix:
Gender:F
Credentials:MA, MFTI #64906
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 S MAIN ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-3255
Mailing Address - Country:US
Mailing Address - Phone:714-966-9999
Mailing Address - Fax:714-966-9996
Practice Address - Street 1:2416 S MAIN ST UNIT B
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-3255
Practice Address - Country:US
Practice Address - Phone:714-966-9999
Practice Address - Fax:714-966-9996
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFTI 64906C101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health