Provider Demographics
NPI:1437321668
Name:NOONOO, KOFI AABA (PHD, LCPC)
Entity Type:Individual
Prefix:DR
First Name:KOFI
Middle Name:AABA
Last Name:NOONOO
Suffix:
Gender:M
Credentials:PHD, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6439 N WASHTENAW AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5305
Mailing Address - Country:US
Mailing Address - Phone:312-655-7037
Mailing Address - Fax:312-236-5384
Practice Address - Street 1:6439 N WASHTENAW AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-5305
Practice Address - Country:US
Practice Address - Phone:312-655-7037
Practice Address - Fax:312-236-5384
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional