NPIMap

Organization Active NPI

K.M. Noonan, PH.D., LLC

  • Clinical Psychologist
  • Duluth, GA
National Provider Identifier
1184750226
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY002952 Issued in GA
Legal business name
K.M. NOONAN, PH.D., LLC
Practice address
3121 Amesbury Way
Duluth, GA 30096-5861
Phone
(770) 490-0975
NPI assigned
Feb 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Katherine Marie Noonan, PH.D.NPI 1518093640
Title
Sole Member
Phone
(770) 490-0975

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY002952 GA Primary

Addresses

Primary practice location

3121 Amesbury Way
Duluth, GA 30096-5861

Mailing address

3121 Amesbury Way
Duluth, GA 30096-5861
Phone (770) 490-0975

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184750226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 AMESBURY WAY",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965861",
            "telephone_number": "770-490-0975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 AMESBURY WAY",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965861",
            "telephone_number": "770-490-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K.M. NOONAN, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NOONAN",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "770-490-0975",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.