Provider Demographics
NPI:1558056754
Name:NOONAN, LAURA MARIE (MS, LPC-A)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:NOONAN
Suffix:
Gender:F
Credentials:MS, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 MAIN ST S STE B2
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798-3738
Mailing Address - Country:US
Mailing Address - Phone:032-633-1752
Mailing Address - Fax:
Practice Address - Street 1:670 MAIN ST S STE B2
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-3738
Practice Address - Country:US
Practice Address - Phone:203-263-3175
Practice Address - Fax:844-364-2702
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6035101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional