Provider Demographics
NPI:1235817891
Name:FLORES, NOAH ELIAS (LMSW)
Entity Type:Individual
Prefix:MR
First Name:NOAH
Middle Name:ELIAS
Last Name:FLORES
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 E WILLIAM CANNON DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-6587
Mailing Address - Country:US
Mailing Address - Phone:469-999-1770
Mailing Address - Fax:
Practice Address - Street 1:706 W BEN WHITE BLVD STE 184
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-8124
Practice Address - Country:US
Practice Address - Phone:469-999-1770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1062501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical