Provider Demographics
NPI:1740574540
Name:CARROLL, NOAH KAI (LCSW)
Entity Type:Individual
Prefix:
First Name:NOAH
Middle Name:KAI
Last Name:CARROLL
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 1:1084 HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-3117
Mailing Address - Country:US
Mailing Address - Phone:610-906-4335
Mailing Address - Fax:
Practice Address - Street 1:3201 HIGHFIELD DR STE F
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-1113
Practice Address - Country:US
Practice Address - Phone:610-663-4248
Practice Address - Fax:484-893-2776
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PACW0184501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health