Provider Demographics
NPI:1669198222
Name:BLAIR, NOELLE (LSCSW)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:BLAIR
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12801 CAENEN ST APT 10210
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4559
Mailing Address - Country:US
Mailing Address - Phone:913-558-8615
Mailing Address - Fax:
Practice Address - Street 1:8700 MONROVIA ST STE 310
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3500
Practice Address - Country:US
Practice Address - Phone:913-558-8615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS054441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical