Provider Demographics
NPI:1457643520
Name:NOONE, KENNETH (LCSW,)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:
Last Name:NOONE
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 1:622 DEVON ST
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-2108
Mailing Address - Country:US
Mailing Address - Phone:609-971-6918
Mailing Address - Fax:
Practice Address - Street 1:622 DEVON ST
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-2108
Practice Address - Country:US
Practice Address - Phone:609-971-6918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC050080001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical