Active NPI
Kim Noonan, LPC
- Professional Counselor
- Dallas, TX
National Provider Identifier
1205713914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 72629
- Practice address
- 10804 Fernald Ave
Dallas, TX 75218-1202 - Phone
- (469) 740-6091
- NPI assigned
- Aug 18, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 72629 | TX | Primary |
Addresses
Primary practice location
10804 Fernald Ave
Dallas, TX 75218-1202
Mailing address
10804 Fernald Ave
Dallas, TX 75218-1202
Phone (214) 274-3652
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72629 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755475200000",
"number": "1205713914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10804 FERNALD AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752181202",
"telephone_number": "214-274-3652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10804 FERNALD AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752181202",
"telephone_number": "469-740-6091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOONAN",
"first_name": "KIM",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-18",
"last_updated": "2025-08-18",
"certification_date": "2025-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "72629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.