Provider Demographics
NPI:1225191158
Name:NOER, LINDA SUSAN (PHD, MSW, LCSW,ACSW)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:SUSAN
Last Name:NOER
Suffix:
Gender:F
Credentials:PHD, MSW, LCSW,ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 S LAYTON BLVD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-1924
Mailing Address - Country:US
Mailing Address - Phone:414-671-5920
Mailing Address - Fax:414-645-7850
Practice Address - Street 1:2219 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53405-3551
Practice Address - Country:US
Practice Address - Phone:262-637-9088
Practice Address - Fax:262-637-3026
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2353-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39556300Medicaid