Provider Demographics
NPI:1831243559
Name:LOR, NOAH POU (MSW)
Entity type:Individual
Prefix:MR
First Name:NOAH
Middle Name:POU
Last Name:LOR
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:MR
Other - First Name:POU
Other - Middle Name:
Other - Last Name:LOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:480 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-6214
Mailing Address - Country:US
Mailing Address - Phone:209-769-8231
Mailing Address - Fax:209-725-3807
Practice Address - Street 1:480 E 13TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341-6214
Practice Address - Country:US
Practice Address - Phone:209-381-6800
Practice Address - Fax:209-725-3807
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW26443101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health