Provider Demographics
NPI:1780313122
Name:JONAIDI, NOORA ASSAD (NCC, LMHC)
Entity type:Individual
Prefix:MRS
First Name:NOORA
Middle Name:ASSAD
Last Name:JONAIDI
Suffix:
Gender:F
Credentials:NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 MEADOWLARK LN SE APT 48
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1090
Mailing Address - Country:US
Mailing Address - Phone:703-956-0443
Mailing Address - Fax:
Practice Address - Street 1:2218 SOUTHERN BLVD SE STE 14
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-3750
Practice Address - Country:US
Practice Address - Phone:505-994-0161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2022-0195101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty