Provider Demographics
NPI:1831992429
Name:ELLIOTT-NOON, KIRSTIN (PSYD, HSPP)
Entity type:Individual
Prefix:
First Name:KIRSTIN
Middle Name:
Last Name:ELLIOTT-NOON
Suffix:
Gender:
Credentials:PSYD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E 91ST ST STE 316
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1556
Mailing Address - Country:US
Mailing Address - Phone:302-521-0274
Mailing Address - Fax:
Practice Address - Street 1:50 E 91ST ST STE 316
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1556
Practice Address - Country:US
Practice Address - Phone:317-550-3221
Practice Address - Fax:317-550-3228
Is Sole Proprietor?:No
Enumeration Date:2025-03-29
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20043894B103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical