Provider Demographics
NPI:1881988699
Name:NOBLE-JOHNSON, KATRI BOLETTE (LCSW)
Entity type:Individual
Prefix:
First Name:KATRI
Middle Name:BOLETTE
Last Name:NOBLE-JOHNSON
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 1:60 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3103
Mailing Address - Country:US
Mailing Address - Phone:518-426-2801
Mailing Address - Fax:518-426-2835
Practice Address - Street 1:401 NEW KARNER RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3854
Practice Address - Country:US
Practice Address - Phone:518-431-1650
Practice Address - Fax:518-447-0429
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker