Provider Demographics
NPI:1326171208
Name:NOAH, PATRICIA ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:NOAH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:COWETA
Mailing Address - State:OK
Mailing Address - Zip Code:74429-2532
Mailing Address - Country:US
Mailing Address - Phone:918-279-6565
Mailing Address - Fax:918-279-6551
Practice Address - Street 1:324 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:COWETA
Practice Address - State:OK
Practice Address - Zip Code:74429-2532
Practice Address - Country:US
Practice Address - Phone:918-279-6565
Practice Address - Fax:918-279-6551
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3328-P1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical