Provider Demographics
NPI:1801104823
Name:NOECKER, JOSEPH (MA, LMHC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:NOECKER
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1759 W BROADWAY ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8128
Mailing Address - Country:US
Mailing Address - Phone:407-737-3676
Mailing Address - Fax:866-550-0602
Practice Address - Street 1:1759 W BROADWAY ST
Practice Address - Street 2:SUITE 3
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8128
Practice Address - Country:US
Practice Address - Phone:407-737-3676
Practice Address - Fax:866-550-0602
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5208101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health