Provider Demographics
NPI:1477083244
Name:ANDERSEN-NOEL, CARMELA KAY (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CARMELA
Middle Name:KAY
Last Name:ANDERSEN-NOEL
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37539 17TH ST E
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-6911
Mailing Address - Country:US
Mailing Address - Phone:661-418-8061
Mailing Address - Fax:
Practice Address - Street 1:1609 E. PALMDALE BLVD. STE D&C
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4881
Practice Address - Country:US
Practice Address - Phone:661-418-8061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF76076106H00000X
CALMFT122788106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist