Provider Demographics
NPI:1528206323
Name:NOONAN, RUTH EVELYN (MA, LPC, MT-BC,FAMI)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:EVELYN
Last Name:NOONAN
Suffix:
Gender:F
Credentials:MA, LPC, MT-BC,FAMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2541 1ST ST
Mailing Address - Street 2:
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-2813
Mailing Address - Country:US
Mailing Address - Phone:970-988-8435
Mailing Address - Fax:970-532-5987
Practice Address - Street 1:545 EAST 5TH STREET
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537
Practice Address - Country:US
Practice Address - Phone:970-988-8435
Practice Address - Fax:970-532-5987
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-02
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5069101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1528206323OtherLPC5069