Provider Demographics
NPI:1578538922
Name:NOBLES, THOMAS KEARNEY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:KEARNEY
Last Name:NOBLES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70A GREENWICH AVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8300
Mailing Address - Country:US
Mailing Address - Phone:646-734-9304
Mailing Address - Fax:
Practice Address - Street 1:70A GREENWICH AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8300
Practice Address - Country:US
Practice Address - Phone:646-734-9304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2007-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072131-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN5I112Medicare ID - Type UnspecifiedPROVIDER NUMBER