Provider Demographics
NPI:1245535798
Name:NOAH, TERESA SUSAN (LMHP, LADC)
Entity type:Individual
Prefix:MISS
First Name:TERESA
Middle Name:SUSAN
Last Name:NOAH
Suffix:
Gender:F
Credentials:LMHP, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13965 HICKORY CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-1151
Mailing Address - Country:US
Mailing Address - Phone:402-990-1342
Mailing Address - Fax:
Practice Address - Street 1:13965 HICKORY CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-1151
Practice Address - Country:US
Practice Address - Phone:402-990-1342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-577101YA0400X
NE9197101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)