Provider Demographics
NPI:1700282068
Name:NOLES, ALICE WADE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:WADE
Last Name:NOLES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9004 COUNTY ROAD 1128
Mailing Address - Street 2:
Mailing Address - City:GODLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76044-3407
Mailing Address - Country:US
Mailing Address - Phone:817-229-7486
Mailing Address - Fax:
Practice Address - Street 1:1300 S UNIVERSITY DR STE 306
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-5746
Practice Address - Country:US
Practice Address - Phone:844-824-8775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-14
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX419661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical