Provider Demographics
NPI:1720364094
Name:NOBLE, PETER (MSW LICSW)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:NOBLE
Suffix:
Gender:M
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 21ST PL SE APT 102
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5424
Mailing Address - Country:US
Mailing Address - Phone:202-439-0450
Mailing Address - Fax:
Practice Address - Street 1:810 POTOMAC AVE SE STE 107
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3633
Practice Address - Country:US
Practice Address - Phone:202-543-0387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3032841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical