Provider Demographics
NPI:1134191406
Name:NOONE, ANNE MARIE LOUISE
Entity type:Individual
Prefix:
First Name:ANNE MARIE
Middle Name:LOUISE
Last Name:NOONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-3048
Mailing Address - Country:US
Mailing Address - Phone:781-765-0096
Mailing Address - Fax:
Practice Address - Street 1:110 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-3048
Practice Address - Country:US
Practice Address - Phone:781-765-0096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3312101YM0800X
MA998106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
7807321OtherAETNA
LM0248OtherBLUE CROSS BLUE SHIELD MA
375604OtherMAGELLAN