Provider Demographics
NPI:1790281756
Name:ZELLER, NOELLE J (LCSW)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:J
Last Name:ZELLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ROSEDALE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-4639
Mailing Address - Country:US
Mailing Address - Phone:203-722-5947
Mailing Address - Fax:
Practice Address - Street 1:1330 POST RD STE 8
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6039
Practice Address - Country:US
Practice Address - Phone:203-722-5947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0077261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT007726OtherLCSW