Provider Demographics
NPI:1447736053
Name:NOBLE, STACY O (LCSW)
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:O
Last Name:NOBLE
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 1:4326 BELLE TERRE DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3204
Mailing Address - Country:US
Mailing Address - Phone:870-515-1394
Mailing Address - Fax:
Practice Address - Street 1:1808 GLENMAR AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-4932
Practice Address - Country:US
Practice Address - Phone:318-327-5344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA52531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical