Provider Demographics
NPI:1710212329
Name:ENTEEN, NOAH E (MFT)
Entity Type:Individual
Prefix:MR
First Name:NOAH
Middle Name:E
Last Name:ENTEEN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 S MOPAC EXPY
Mailing Address - Street 2:#835
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:415-310-9665
Mailing Address - Fax:512-790-4638
Practice Address - Street 1:2301 S MOPAC EXPY
Practice Address - Street 2:#835
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:415-310-9665
Practice Address - Fax:512-790-4638
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50798106H00000X
TX202647106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist