Provider Demographics
NPI:1134406648
Name:NOEL, JACQUELINE (LPC)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:NOEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 E HIGHLAND MALL BLVD STE 260-14
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-3735
Mailing Address - Country:US
Mailing Address - Phone:773-719-4628
Mailing Address - Fax:
Practice Address - Street 1:314 E HIGHLAND MALL BLVD STE 260-14
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3735
Practice Address - Country:US
Practice Address - Phone:773-719-4628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67016101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285502502Medicaid